Bupa Dental Choice - benefit schedule

Examination

a

5.84

7.01

11.85

14.22

20.00

24.00

Examination (new patient)

c

18.24

21.89

26.78

32.14

30.00

36.00

Small X-ray

b

3.62

4.34

4.12

4.94

7.00

8.40

Medium X-ray (per film)

b

3.80

4.56

6.18

7.42

10.00

12.00

Panoral

c

8.92

10.70

15.45

18.54

22.00

26.40

Scaling

Simple

b

9.20

11.04

13.91

16.69

30.00

36.00

Chronic periodontal per visit:

1-4 teeth

28.32

33.98

33.48

40.18

45.00

54.00

5-9 teeth

34.60

41.52

46.35

55.62

55.00

66.00

10-16 teeth

40.88

49.06

51.50

61.80

60.00

72.00

17 or more teeth

45.88

55.06

61.80

74.16

70.00

84.00

Fillings

Amalgam:

1 surface

10.14

12.17

15.45

18.54

34.00

40.80

2 surfaces

13.34

16.01

23.18

27.82

42.00

50.40

3 surfaces or more

19.85

23.82

30.90

37.08

46.00

55.20

Composite anterior:

1 surface

15.73

18.88

27.04

32.45

46.00

55.20

2 surfaces or more

22.01

26.41

29.50

35.40

50.00

60.00

Composite posterior:

1 surface

17.60

21.12

30.90

37.08

55.00

66.00

2 surfaces or more

22.41

26.89

38.63

46.36

63.00

75.60

Root canal treatment

Single root

25.72

30.86

65.66

78.79

125.00

150.00

Two roots

37.92

45.50

115.88

139.06

146.00

175.20

Multiple roots

62.48

74.98

136.99

164.39

163.00

195.60

Surgical treatment

Extraction (per tooth)

10.40

12.48

23.18

27.82

30.00

36.00

Surgical extraction flap raised)

39.64

47.57

38.63

46.36

48.00

57.60

Apicectomy

48.24

57.89

115.88

139.06

140.00

168.00

Incising of abscess

7.39

8.87

17.51

21.01

23.00

27.60

Crowns, bridges etc

Inlay (per tooth)

90.36

122.30

135.19

162.23

213.00

255.60

Veneer (per tooth)

74.28

90.23

135.19

162.23

184.00

220.80

Full gold crown

82.84

99.41

212.44

254.93

260.00

312.00

Porcelain crown

60.64

72.76

180.25

216.30

250.00

300.00

Porcelain bonded to metal crown

92.28

110.74

212.95

255.54

250.00

300.00

Bridge per unit

97.64

117.17

216.30

259.56

260.00

312.00

Adhesive bridge

106.97

128.36

247.20

296.64

290.00

348.00

Cast post core

25.64

30.77

46.35

55.62

75.00

90.00

Prefabricated post and core

13.40

16.08

13.21

15.85

15.00

18.00

Refix or re-cement existing crown

7.68

9.22

15.45

18.54

20.00

24.00

Re-cement adhesive bridge

11.74

14.09

19.31

23.17

25.00

30.00

Re-cement any other bridge

11.74

14.09

19.31

23.17

25.00

30.00

Dentures

Acrylic partial upper or lower

78.00

93.60

193.13

231.76

200.00

240.00

Acrylic partial upper and lower

156.91

188.29

347.63

417.16

400.00

480.00

Metal partial upper or lower

139.92

167.90

309.00

370.80

360.00

432.00

Metal partial upper and lower

279.85

335.82

540.75

648.90

600.00

720.00

Acrylic full upper or lower

78.92

94.70

212.95

255.54

210.00

252.00

Acrylic full upper and lower

126.48

151.78

386.25

463.50

420.00

504.00

Re-line denture

28.32

33.98

30.90

37.08

35.00

42.00

Addition of tooth

19.76

23.71

30.00

37.08

35.00

42.00

Repair of denture

8.40

10.08

19.31

23.17

22.00

26.40

Occlusal splint

68.27

81.92

118.45

142.14

135.00

162.00

Annual limits

a Max twice per year

b Max four per year

c Max once per year

Routine treatment

450.00

(540.00)

775.00

(930.00)

1500.00

(1800.00)

Accident/sport injuries

300.00

(360.00)

460.00

(555.00)

600.00

(720.00)

Emergencies

150.00

(180.00)

309.00

(370.00)

400.00

(480.00)

No health checks prior to joining
All pre existing conditions covered in the event of routine treatment
Use of plan from commencement
Free choice of dentist
Oral cancer (pre-existing conditions) £10,000