Dental Savings Plan
We now
offer an In-House Dental Savings Plan. This plan was designed for our patients without dental insurance.
Also, you may enroll and use this plan in conjunction with your dental insurance for “non-covered
services” only, or if you have reached maximum benefits with
an out-of-network insurance provider.
Once benefits resume, the DSP
can no longer be used for covered services.
Patient Form
This is a
dental discount plan and is NOT dental insurance.
- Annual fee is
$150.00 for first person and $100.00 for each additional household member. This plan is
non-transferable.
- Family members
cannot be substituted for other family members. Enrollees must be stated at the time of
enrollment.
- Term of the dental
savings plan (DSP) is 1 year from date of enrollment.
- This plan has no
maximums, deductibles, claim forms, pre-authorizations, waiting periods, missing tooth clauses or
pre-existing condition exclusions.
- This plan is only
valid at Gentle Family Dentistry, LLC. It is not an insurance plan which can be used in other dental
offices.
- All treatment must
be paid in full at each visit to keep the plan in effect. No exceptions. Any service not paid at
time of visit will be billed at GFD standard rates.
- Annual enrollment
fees paid for each person must be paid in full on/or before their first visit and are
non-refundable.
- Annual enrollment
fees are due on the first appointment of the enrollment month, or can be scheduled to be paid
automatically on renewal date.
- Plan and
enrollment fee are subject to change annually without notice.
- No refunds will be
issued at any time if participant does not utilize dental plan.
- You may enroll and
use this plan in conjunction with your dental insurance for “non-covered services” only, or if you
have reached maximum benefits with an out-of-network insurance provider. Once benefits
resume, the DSP can no longer be used for covered services.
This is NOT a dental
insurance plan. This is a dental savings plan for eligible members. It CANNOT be
used:
- For cosmetic or theraputic injectables
- Nitrous
oxide
- With CareCredit or
beWell if purchase price is under $1,000.00
- In conjunction
with any other plan or offer with exception to non-covered services or out-of-network plans where
maximum benefits have been reached.
- For cost of care
covered under workman’s comp or medical, automobile, disability insurance or any other type of
insurance
- For referrals to
specialists
- For treatment
which, in sole opinion of the treating dentist, lies outside the realm of his/her
capability
- For
hospitalizations or hospital charges of any kind
- For services
which, in the opinion of the attending dentist, are not necessary nor recommended for the patient’s
health
- For services which
cannot be performed because of the general health, physical or psychological limitations of the
patient
- For any retail
product sold in the office including all oral health products and take-home whitening
products
For additional questions or concerns, please
contact our office by calling us at (410) 257-2424 or you can email us at office@dunkirkdental.com. We will be happy to
help you during normal business hours.