Demir Sağlık Complication Insurance

Complications, which may be reimbursed under dental plan are expenses, which arise following tooth extraction, surgical tooth extraction, root canal operation, implant operation, prosthetic tooth application and periodontology applications. Orthodontic treatments are excluded from coverage.

In prosthetic tooth application, problems, such as undesired color or form of prosthesis, will not be deemed as complication and no reimbursement will be made.

In surgical tooth extraction, complications, such as delayed hemorrhage, gingiva infection, leaving a part of tooth; in implant applications, ill-fitting implant, loose implant, dislodged implant and inflicting damage on jaw bone, are excluded from coverage

Eye plan includes coverages for complications, which may arise due to corrective procedures, such as excimer laser and lasik, cataract surgery, ptosis surgery, glaucoma surgery and retina detachment surgery.

Flap dislocation in excimer laser surgeries, keratitis, development of epithelia under flap, more than 0.75 degrees visual impairment in the examination, performed 60 days after surgery;

In cataract surgeries; hemorrhage, perforation of eye, tearing of lens capsule, loss of transparency of cornea layer, burns at incision site, cataract parts remaining in the eye, infection, retina detachment, edema in yellow spot, disturbance and pain in the eye, droopy eyelids, glaucoma and/or double vision; more than 1 degree visual impairment in the examination, performed 60 days after surgery, opacification of rear capsule;

In ptosis surgery, relapse of droopy eyelid,

In retina detachment surgery, relapse of detachment, intraocular hemorrhage, formation of cataract and glaucoma;

In glaucoma surgery, conjunctival tearing, scleral flap damage, loss of vitreus, loss of central visual field, decompression retinopathy, infection, bleb leakage, supracoroidal hemorrhage, uveitis, are included in coverage

In hair transplantation plan, complications, arising as a result of patient’s non-compliance with the recommendations of physician (early hair combined and brushing, failure to comply with hair washing procedure, failure to apply necessary care) and failure of hair transplantation, are excluded from coverage.

Despite compliance with all these recommendations, non-retention of hair follicles or treatments for infection in the skin and repetition of hair transplant, are included in coverage. For reimbursement of claims, it must be determined with a physician report that recommendations were followed following hair transplantation.

In revision transplantation, transplantation, exceeding the number of transplantations in the original procedure, are excluded

In all surgical procedures, the complications, given in informed consent form, signed by patient, are under the coverage. (Except death).

As invasive procedures, coronary angiography, balloon angioplasty, stent application, colonoscopic or gastroscopic removal of polyps, are covered. ERCP applications are excluded.

In coronary invasive procedures, only the restenosis following stent application, stent displacement may be deemed as complications.

Among gynecological procedures, complications following ceaseraean section (other than early complications, such as hemorrhage and uterus rupture), are covered.

In plastic surgeries revision requests due to failure to comply with personal liking, will not be reimbursed. However, failure of surgery (nasal tip drop after rhinoplasty; remaining deviation; nasal septum perforation; asymmetry in breast surgery, dropping, implant perforation and capsular contracture) are under coverage.

Botox applications are excluded

Possible complications, specified in literature for related surgery, such as restenosis, stent shift, following a surgery/procedure, such as peripheral vascular surgery, varicosele surgery, heart valve replacement, valvuloplasty, cornary arterial bypass surgery, coronary stent application, large vessel replacement, in a healthcare institution in Turkey, are covered.

Demir Sağlık ve Hayat Sigorta A.Ş., may obtain a second opinion when necessary from an independent expert in the assessment of reimbursement claims of insured. Demir Sağlık ve Hayat A.Ş is the ultimate decision maker for reimbursements of complication claims.

In all these cases, requiring surgical or medical procedures, accommodation and other expenses for companion in healthcare institution and other expenses and transportation and hotel accommodation expenses, are not reimbursed. (In case of purchase of additional companion plan, transportation (flight) and hotel accommodation expenses for companion are reimbursed subject to coverages).

This plan has a wider coverage limit and period compared with standard dental plan. All other coevrages and practices are same as standard Dental Plan. This plan covers complications arising within 12 months after policy issuing date.