In House Dental Plan
In-Office Discount Dental Plan
Download In-House Dental Plan
Welcome to the Collegeville Dental Center In-Office Dental Discount Plan. This plan was developed especially for patients who do not have dental insurance or whose employer no longer provides it. As regular dental care is an integral part of your overall health, we have created this plan to support you in your efforts. We hope that you utilize this plan to improve and maintain oral health for yourself and your family for years to come. Keep in mind that this plan is not dental insurance, but it has a number of great features that are very exciting:
· No annual maximum benefit
· No waiting periods--start your treatment today!
· No deductibles
· No Claim Forms or Pre-Authorizations
· No ID Card Necessary
· Two Routine Exams
· Two Bitewing X-rays (children) or Four Bitewing X-rays (adult)
· Two Routine Cleanings
· Two Topical Fluoride Application for children up to age 16
· One Emergency Exam and X-ray
· All eligible dental treatment discounted by 20% when paid in full at the time of service
Payment of enrollment fees initiates coverage.
Single Members $325
Adult Household Member $305 per person
Dependents 25 & under $190 per person
How to enroll
· Complete the Enrollment Application
· Pay enrollment fee in full to activate membership
Please don't hesitate to contact us if you have any questions about enrollment or covered services. Visit us at www.555Dental.com for additional information. Please mail completed applications and enrollment fee to:
Collegeville Dental Center
555 North 2nd avenue Bldg. D-500
Collegeville, PA 19425
Policies and Exclusions
· This plan is only good at Collegeville Dental Center.
· This in-office discount plan is not dental insurance.
· To be an independent member, you must be 18 or older. Your eligible dependents include your spouse or domestic partner and your children through the age of 25.
· This plan cannot be combined with any other dental insurance.
· This plan cannot be combined with any other offers.
· If the patient has and elects to use dental insurance, insurance plan fees, payments, and deductibles will apply.
· All patients are subject to Collegeville Dental Center office policies.
· All payments are due at the time of service to receive the discount. Any services that are not paid in full at the time service will be billed at our regular fees.
· Enrollment fees must be paid in full to receive discounts.
· All payments are nonrefundable
· No refunds Will be given if a member and/or spouse or children do not use the plan, relocate, or obtain dental insurance.
· 12-month term effective from sign up date to renewal date.
· Veneers, Invisalign, and orthodontic treatment are discounted 10%.
· Plans and fees are subject to change yearly.
· No discount will be offered for services requiring referral to a specialist. Referral to specialist is at the discretion of the doctor.
· Should treatment be needed following an injury or 3'd party outside insurance is involved, this cannot be used.
· Treatment initiated prior to enrollment is not eligible for discount.
· Prostheses delivered or in-progress treatment completed more than 60 days after termination of coverage is not eligible for discount.
· Periodontal therapy including scaling and root planning is covered by 20% discount.
· Treatment fees are guaranteed for 3 months from the date quoted by the office.
· Collegeville Dental Center reserves the right discontinue this plan for any member at any time.
· Two no-shows or cancellations without 24-hour notice can lead to you being dropped from this plan without a refund.
· If you choose to extend your payment for treatment by paying through Care Credit, the treatment discount is reduced to 15% due to merchant fees.