FAQs

WHAT IS OCARE?

OCARE is a revolutionary subscription which has the first ever Dental Insurance for India. This subscription has been conceptualized, built and provided by PLAN DENTAL LLP. This subscription is open to groups and not available as a retail offering. These groups can include Companies, Schools, Institutions and Associations.


ABOUT OCARE GROUP INSURANCE SCHEME?

The group insurance includes a subscription package in which we provide

  • Oral hygiene kit
  • OCare dental insurance with a S.A 25000/annum/person
  • Loyalty card: Points redeemable for dental service
  • Bi-annual dental check-ups and cleaning free
  • 15%discount on elective and cosmetic dental procedures

FAQ - For Customers


Q. I have a Mediclaim policy. Do I still need dental insurance?

Yes, you need dental insurance. Your existing medical policy does not cover dental treatment.


Q. What if I am or my family member is already suffering from a dental disease? Can i yet get myself or my family members covered?

Yes, all pre-existing conditions are covered in the OCare subscription. The policy can be availed by you or your family member if enrolled individually with the subscription as part of a group.


Q. Does this scheme have cashless facility?

Currently this is a reimbursement policy. Once you file for the claim the reimbursement will reach to your account within 30 working days.


Q. Can I have the policy number?

All this information shall b available in the Insurance policy certificate issued to you along with the welcome kit.


Q. If I have a health insurance policy in Mumbai, can i make a claim if i am transferred to Delhi?

Yes, your dental insurance is valid across the listed cities.


Q. Are all the tests prescribed by the dentist at the clinic reimbursed under the health insurance plan?

The first Pre-Treatment OPG is reimbursed with this policy. The reimbursement will be made when the first claim is made. This policy does not reimburse other investigations when and as requested by your dentist.


Q. What happens when the limit of insurance is exhausted under the insurance policy?

The insurance coverage is limited to an upper limit of INR 25000 only. If the sum insured is exhausted in a particular year due to large expenses, the insurer is not liable to bear/reimburse the insured for any further expenses.


Q. What is the claim procedure?

The claim procedure is completely online. It has to be completed at the dentist clinic only after the completion of treatment. Your treating Dentist will guide you for the claim procedure.


Q. Who will receive the claim amount if the insured dies after the treatment but before reimbursement?

It will be reimbursed electronically to the subscriber’s bank account.


Q. What are sub-limits in this policy?

The sub-limits are listed in the terms and conditions.

AGE: 18+ Years
TREATMENT ANNUAL SUB LIMITS
(IN INR)
Oral Surgery Extraction - Basic 400
Impaction/surgical 6000
Prosthodontics Ceramo Metal 4000
Metal 2000
Complete Denture 8000
Partial Denture 4000
Endodontics Root Canal Treatment 4000
AGE: 1-18 Years
TREATMENT ANNUAL SUB LIMITS
(IN INR)
Oral Surgery Extraction - Basic 400
Impaction/surgical 6000
Prosthodontics Ceramo Metal 4000
Metal 2000
Orthodontic Treatment 8000
Space Mainatiner 2000
Endodontics Root Canal Treatment 4000

Q. How is the sub limit defined?

The sub limit is the maximum amount that will be reimbursed peryear per specific type of treatment sub-category. Eg: The sub limit for Root Canal Treatment is Rs. 4000/-, the maximum amount reimbursed in a year will be Rs. 4000 be it for single or multiple Root Canal treatments

FAQ – from dentists


Q. How do I become a networked dentist?

The sub limit is the maximum amount that will be reimbursed peryear per specific type of treatment sub-category. Eg: The sub limit for Root Canal Treatment is Rs. 4000/-, the maximum amount reimbursed in a year will be Rs. 4000 be it for single or multiple Root Canal treatments


Q. What are the benefits of being a participating dentist?

There are a number of benefits:

  • You get empanelled with us which basically leads to increase in the no of patients for you to treat.
  • You get an intraoral camera.
  • Also Professional indemnity insurance of 10 Lakh rupees.


Q. Is there a charge to join in your Network?

You have to pay a membership fee of Rs 3000 + service tax. (Total = 3450)


Q. If I don't participate with Ocare, do my patients still reap the benefits?

No (Yes but at other clinics who are empanelled with us)


Q. Do I need to notify Ocare of changes; if any, related to my practice?

Yes, you have to notify our support team.


Q. How do I determine the patient benefits and eligibility?

Benefits and eligibility of the patients will be informed to the patients at the time of enrolling. You can go through the terms and conditions on our website www.ocare.com


Q. I'm facing problems checking my patient's benefits and eligibility because he or she doesn't know their subscriber ID?

You can contact our support team with the name of the patient and they will help you out with the same.


Q. What is the standard turnaround time for claims processing?

The standard turnaround time is as follows:

  • 4 hours in case of regular cases
  • 1 hour in case of emergency cases
  • 10 -15 minutes in case of critical emergency


Q. How do I check on the status of a claim?

You can check the status of the claim by visiting your dashboard (after log in)


Q. What do I do in case of any more queries?

Feel free to contact us on: 1800 0000 0000 or u can visit our website: www.ocare.com


Q. The patient is not getting the amount as mentioned in the sub limits on the form?

The sub limits/capping mentioned in the form are the maximum limits that can be reimbursed for that case.