COSMODENT CONSERVATIVE DENTISTRY BENEFIT PLAN

Affordable Routine Dental Care for You and Your Family

The Cosmodent Conservative Dentistry Benefit Plan (CCDP) is an in-house dental care plan in Oude Westhof, Bellville, Cape Town. From R220 per person per month, it provides access to listed routine and preventative dental treatments after a three-month waiting period.

The CCDP is not medical aid or dental insurance. It is provided solely by Dr Andre M Dumas at Cosmodent. Terms and conditions apply.

Questions before applying? Chat to Cosmodent on WhatsApp.

R220

per person, per month

3 months

waiting period

2 years

minimum contract period

Family applications

One main member, one qualifying spouse or partner and up to four children.

WHAT THE PLAN IS

A Practical In-House Dental Plan in Bellville

The CCDP helps individuals and families plan for listed routine dental care through one predictable monthly contribution.

Many South Africans use medical savings or day-to-day benefits for routine dentistry. When those funds are limited or exhausted, patients may need to pay dental accounts themselves. The CCDP is designed as a separate, in-practice option for eligible Cosmodent patients who want structured access to listed conservative and preventative treatments.

It does not replace medical aid, and specialised dentistry is not included.

Predictable Monthly Cost

R220 per person per month for the main member and each accepted dependant.

Routine Dental Care

The plan focuses on listed conservative, preventative and emergency dental treatments.

Family Applications

Apply for one main member, one qualifying spouse or partner and up to four children under 18.

Local Care in Bellville

Covered treatment is provided solely by Dr Andre M Dumas at Cosmodent in Oude Westhof.

WHAT IS INCLUDED

Routine and Preventative Dental Benefits

The CCDP covers only the treatments and annual limits listed in the signed agreement. The summary below highlights the main benefits. Full clinical codes, limits and exclusions appear in the application.

Check-ups and Consultations

Unlimited consultations, with two oral examinations and treatment sessions per year.

Professional Cleaning

Two prophylaxis or professional cleaning treatments, plus oral hygiene instruction, each year.

Emergency Dental Care

Unlimited emergency dental treatment, pulpotomy and local anaesthetic where clinically indicated.

X-rays

Four intraoral radiographs per patient per year under the plan.

Fillings and Restorations

Four listed restorations or fillings per patient per year.

Extractions and Fluoride

Unlimited listed extractions, plus two annual topical fluoride applications for adults and children.

WHO THE CCDP MAY SUIT

Built for People Who Want More Predictable Routine Dental Costs

The CCDP may suit adults and families who want a structured way to access listed routine dental care at Cosmodent without relying only on available medical savings.

Approval is subject to the completed application, supporting documents and the plan’s terms.

Individuals looking for an affordable dental plan in Cape Town
Families seeking routine and preventative dental care in Bellville
Medical aid members who want to protect available day-to-day savings
Existing or prospective Cosmodent patients comfortable using one designated provider

HOW TO APPLY

A Clear Four-Step Application Process

The online form separates the application into seven short screens, so applicants can complete one clear group of information at a time.

1. Complete the Form

Provide the main member, dependant, employment, reference and financial information.

2. Review the Terms

Read the benefits, exclusions, waiting period, payment conditions and contract requirements.

3. Upload Documents

Upload identity documents, proof of address, three bank statements and three payslips.

4. Cosmodent Reviews

Submitting the application does not activate the plan. Cosmodent will review it and contact the applicant.

READ BEFORE APPLYING

Important CCDP Terms at a Glance

Transparent plan information helps applicants decide whether the CCDP matches their needs before they submit personal and financial documents.

Not medical aid or insurance

The CCDP is an in-house benefit plan offered by Cosmodent.

Three-month waiting period

Benefits begin only after the waiting period and activation requirements are met.

Minimum two-year contract

Early termination and cancellation conditions apply.

One designated provider

Covered treatment is rendered solely by Dr Andre M Dumas at Cosmodent.

Specialised dentistry excluded

Root canal treatment, core build-ups and pins, temporary or resin crowns, orthodontics and unlisted procedures are not covered.

Documents are compulsory

The plan is not activated without the required identity, address, bank-statement and payslip documents.

START YOUR APPLICATION

Apply for the Cosmodent CCDP

Complete the seven-step application below. Have the required ID documents, proof of address, three bank statements and three payslips ready before you begin.

Your application is reviewed by Cosmodent and is not active until Cosmodent confirms acceptance and activation.

Personal information notice: The application contains identity, contact, employment, financial and health-related information. Submit documents only through the official Cosmodent form.

Step 1 of 7

Main Member Details

Enter the details of the person responsible for the CCDP agreement.

Title *

First names *

Surname *

South African ID number * Enter the 13-digit number without spaces.

Marital status *

Cellphone number *

Home telephone number

Work telephone number

Email address *

Address Details

Postal address *

Postal code *

Physical address *

Postal code *

Step 2 of 7

Dependants

Add the spouse, partner or children who must be included under the plan.

Who may be added?

Spouse or partner: A legal spouse or qualifying partner who has lived with the main member for six months or longer. Only one spouse or partner may be covered.

Child dependant: A biological, adopted or legally guarded child under 18 years old. A maximum of four children may be added.

Are you adding a spouse or adult dependant? * YesNo

Spouse or Adult Dependant

Full names *

Surname *

ID number or date of birth *

Contact number *

Relationship to main member *

How many child dependants are you adding? *

Child 1

Full names *

Surname *

ID number or date of birth *

Child 2

Full names *

Surname *

ID number or date of birth *

Child 3

Full names *

Surname *

ID number or date of birth *

Child 4

Full names *

Surname *

ID number or date of birth *

Step 3 of 7

Employment and Reference

Provide your occupational details and a reference who does not live at your address.

Occupational Information

Occupation *

Position *

Company name *

Company address *

Company telephone number *

Company cellphone number

Company email address

Reference Not Living at the Same Address

The reference must not live at the same physical address as the main member.

Title *

First names *

Surname *

Relationship to main member *

Cellphone number *

Home telephone number

Work telephone number

Email address *

Postal address *

Postal code *

Physical address *

Physical address postal code *

Step 4 of 7

Financial Information

Answer the following financial questions accurately.

Are you currently under debt review, or do you plan to enter debt review in the foreseeable future? * YesNo

Please provide details *

Have you ever been sequestrated, or are you currently in the process of being sequestrated? * YesNo

Please provide details *

Are you currently under administration, or do you expect to be placed under administration in the foreseeable future? * YesNo

Please provide details *

Monthly Contributions

Main member R220 per month

Adult dependant R220 per month

Each child dependant R220 per month

I understand that the monthly contribution is R220 for every person included in this application.

Step 5 of 7

Benefits and Exclusions

Review the annual benefits and the treatments that are not covered.

Benefits Available Per Year

Unlimited consultations
Two oral examinations and treatments annually
Unlimited infection control
Unlimited sterilisation of instruments
Two professional cleaning treatments annually
Two oral hygiene instruction sessions annually
Two re-burnishing and polishing treatments annually
Two complete dentition polishing treatments annually
Two topical fluoride applications annually for children
Two topical fluoride applications annually for adults
Unlimited emergency dental treatment
Unlimited pulpotomy treatment
Four intraoral radiographs annually
Unlimited local anaesthetic
Unlimited extractions
Four restorations or fillings annually per patient

Specialised Dentistry Not Covered

Root canal treatment, including preparation and filling of the root canal
Core build-ups and pins
Temporary or resin crowns
Orthodontic treatment
Any treatment or procedure not specifically listed as covered

Important Payment Information

Specialised dentistry must be paid for separately by the patient.

Orthodontic treatment requires a deposit of R12,000 before treatment may begin.

Crown and bridge treatment requires a 50 percent deposit before treatment may begin.

A missed appointment without prior cancellation will result in a R750 fee.

I understand that the CCDP covers only the listed normal and basic dentistry benefits. I understand that specialised dentistry and procedures not listed as covered must be paid for separately.

Step 6 of 7

Payment and Contract Terms

Read each section carefully before accepting the agreement.

Payment Terms

Cosmodent will not submit a debit order on behalf of the member.
The main member must arrange a debit order or stop order with their bank within 30 days of entering the agreement.
Payment must be made monthly in advance on the first day of each month.
A failed or defective payment must be corrected within the period stated in the agreement.
Failure to correct payment may result in the plan lapsing and legal recovery action.
The member remains responsible for outstanding contributions, recovery expenses and legal costs.
Accounts outstanding for more than 60 days will attract interest of 3 percent.

Contract Terms

The plan has a three-month waiting period.
The contract is valid for a minimum period of two years.
Dr AM Dumas is the sole dental service provider under this plan.
Only procedures and codes specifically listed in the contract are covered.
The member is responsible for confirming whether proposed treatment is covered.
The member remains responsible for treatment and charges not covered by the plan.
Cosmodent may adjust the contribution after giving the notice required by the agreement.
Early termination may make the member liable for the remaining contract contributions and associated costs.
After the initial contract period, the agreement may continue on a month-to-month basis.
Cancellation must be submitted in writing three months in advance.
The contract may only be terminated by the main member after all outstanding amounts have been paid.

Required Acceptances

I accept the monthly contribution, payment and outstanding-account conditions.

I understand and accept the three-month waiting period.

I understand and accept the minimum two-year contract period and the cancellation conditions.

I understand that Dr AM Dumas is the sole dental service provider under this plan.

I accept responsibility for treatment, procedures and amounts that are not covered by the plan.

I accept responsibility for all outstanding amounts payable under this agreement.

Step 7 of 7

Documents and Signature

Upload the required documents and complete the final declaration.

Required Documents

No contract will be activated unless all required documents are submitted.

Accepted file types: PDF, JPG, JPEG and PNG. Maximum file size: 2 MB per file.

Identity and Address Documents

Main member ID document *

Spouse or adult dependant ID document *

Child 1 ID document or birth certificate *

Child 2 ID document or birth certificate *

Child 3 ID document or birth certificate *

Child 4 ID document or birth certificate *

Proof of residential address *

Three Months of Bank Statements

Month 1 *

Month 2 *

Month 3 *

Three Months of Payslips

Month 1 *

Month 2 *

Month 3 *

Privacy and Consent

I consent to Cosmodent processing the personal information contained in this application for the administration of the CCDP agreement.

I consent to relevant personal and medical information being processed or lawfully shared where required to provide treatment, administer the agreement or comply with legal obligations.

I consent to diagnostic imaging, dental procedures and treatment instructions where clinically required and discussed with me.

Final Declaration

Full legal name of main member *

Main member ID number *

Application date *

I confirm that all information supplied in this application is true, accurate and complete. I confirm that I have read and understood the benefits, exclusions, monthly contributions, payment conditions, contract terms, supporting-document requirements and privacy consent. I understand that submitting this form constitutes my application to enter into the Cosmodent Conservative Dentistry Benefit Plan agreement.

Main member signature *

Sign inside the signature box before submitting.

COMMON QUESTIONS

Cosmodent CCDP Frequently Asked Questions

These answers summarise the current CCDP application pack. The signed agreement and Cosmodent’s final assessment control the application.

What is the Cosmodent CCDP?

The Cosmodent Conservative Dentistry Benefit Plan is an in-house dental care plan for listed routine, preventative and emergency treatments provided at Cosmodent in Oude Westhof, Bellville. It is not medical aid or dental insurance.

How much does the CCDP cost?

The current contribution is R220 per person per month. The same monthly amount applies to the main member, one accepted adult dependant and each accepted child dependant.

Can I add my family?

The application allows one qualifying spouse or partner and up to four biological, adopted or legally guarded children under 18, subject to the agreement and supporting documents.

When do the benefits start?

A three-month waiting period applies. Submitting the form does not activate the plan. Cosmodent must review the application and required documents before activation.

What treatments are not covered?

Specialised dentistry is excluded, including root canal treatment, core build-ups and pins, temporary or resin crowns, orthodontics and any treatment not specifically listed as covered.

Which documents must I submit?

The application requires identity documents for the main member and dependants, proof of address, three months of bank statements and three months of payslips.

Need Help Before You Apply?

Speak to Cosmodent if you are unsure about eligibility, benefits, excluded treatment or the documents required for the application.

Cosmodent
6 Pontac Street, Oude Westhof, Bellville, 7530
021 913 9025 · doctor@cosmodent.co.za