Dental Savings Plan
Our commitment to providing the best possible dental care doesn't end simply with patients who have access to dental insurance. With that in mind, we have crafted an inhouse dental savings plan (DSP) to provide affordability and greater access to quality dental care.
With your comprehensive dental plan there are:
- No Yearly Maximums
- No Deductibles
- No Claim Forms
- No Waiting Periods
- No Preauthorization Requirements
- No Pre-Existing Condition Clauses
Cost of Plan
| Total Annual Cost | |
|---|---|
| Child | $315 |
| Adult | $365 |
| Adult Perio | $425 |
Program Guidelines
The cost of the Walsworth Family Dentistry Membership Plan is subject to change annually.
The cost of the plan is NON-REFUNDABLE. No refunds will be issued if patient elects not to utilize.
Plan's effective date and record of usage will be maintained by DFD.
Patients portion of bill is due on day of service.
Coverage Tables
Diagnostic And X-rays
| Treatment | Member Discount |
|---|---|
| Comprehensive Exam (new patient, lnltla/vlslt) |
100% |
| Periodic exam (2 per year) | 100% |
| Full mouth Radiographs Or panorex (every 3-5 years) |
100% |
Preventative
| Treatment | Member Discount |
|---|---|
| Child prophylaxis (cleaning) (2 per year) Additional Visits |
100% |
| Adult Prophylaxis (cleaning) (2peryear) Additional visits -or with Perio plan- |
15% |
| Adult Periodontal Maintenance (2 per year) | 100% |
| Additional visits | 15% |
| Fluoride (2 per year,no age limit) |
100% |
All Other Procedures
| Treatment | Member Discount |
|---|---|
| Filling | 15% |
| Whitening | 15% |
| Crowns | 15% |
| Periodontics (General dentistry) Dentures and Partials | 15% |
| Oral Surgery (extractions) | 15% |
| Root Canals | 15% |
| Implants (Placement and Restoration) Sealants | 15% |
Program Exclusions and Limitations
This program is a discount plan, not a dental insurance plan. It cannot be used:
- In conjunction with dental insurance or another dental plan
- For services or injuries covered under workman's compensation
- For treatment which, in the sole opinion of the treating dentist, lies outside the realm of his/her capabilities
- For referrals to specialists
- For hospitalization of hospital charges of any kind
- For costs of dental care which are covered under automobile, homeowners, or medical insurance
OCR Notice of Nondiscrimination
Walsworth Family Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color national origin, age, disability, or sex.