Dental Membership Plan

A Membership Plan To Fit Your Needs

Brown Family Dentistry is pleased to present you with information of an in-house membership plan that we are making available to our patients. Our membership plan is an affordable alternative for individuals of all ages who want excellent dental care and do not have existing insurance or anticipate discontinuing their current dental insurance.

Our plan is designed to include preventive services at a frequency determined for optimal oral health. The plan also provides a discount of 12-20% on other dental services.

The cost of an adult plan (age 14 and older) is $500 annually.

The cost of a child plan (age 13 and younger) is $400 annually.

Plan Includes:

¨Two exams per plan year

¨ Two routine cleanings per plan year

¨ Fluoride treatments—any age (unlimited)

¨ All necessary radiographs (excluding cone beam scans)

¨ Two emergency exams per year

¨ Oral cancer screening

¨ Two periodontal maintenance cleanings at 50% discount

¨ Additional periodontal maintenance cleanings  and treatment of periodontal “gum” disease (including but not limited to scaling and root planing or periodontal surgery) at additional services discount

¨ 15% discount on additional services when paid by cash or check (12% discount when paid by credit card)

¨ 20% discount for seniors (age 60 and older) on additional services when paid by cash or check (17% discount when paid by credit card)

 Terms and Conditions:

This program is not a dental  insurance plan. It cannot be used:

¨ In conjunction with another dental benefit, such as dental insurance

¨ In conjunction with any third party financing such as Care Credit

¨ For services or injuries covered under workers compensation, medical insurance, general liability, etc.

¨ For treatment, which in the sole opinion of the treating dentist or doctor, lies outside the realm of their capability

¨ For treatment provided by specialists or another office

¨ For treatment provided by covering on-call doctors

¨ For hospitalizations or hospital charges of any kind

¨ For office dispensed products

 Payment Terms:

¨ Membership fee is due in full upon joining

¨ Payment for additional services is due when services are rendered

¨ Refunds will not be provided for dues paid, including failure to schedule and maintain appointments

¨ Fees for dental services may change at any time

¨ The membership auto renews 15 days prior to expiration with credit card on file