No Dental Insurance? We Can Help!

We know that dentistry is expensive and often that means people don’t take care of their teeth.  Our office is happy to offer a membership to make great dental care more affordable.  Take care of your mouth by taking advantage of our great in-house membership.

Coverage Includes

  • New Patient Comprehensive Exam                $110 value  
  • Periodic Exam (2 per year)                              $120 value
  • Cleanings or Perio Maintenance (2 per year) $220 or $320 value
  • Full Mouth Series of X-rays (1 every 5 years) $160 value
  • Bitewing X-rays (1 time a year)                       $80 value
  • Periapical X-ray (3 total a year)                       $115 value
  • Fluoride (1 every year)                                     $60 value
  • 15% Discounts on Dental Procedures– Excluding SureSmile

Up to a $345 savings for new prophy patients

Up to a $245 savings for existing prophy patients

Plan Benefits

  • No Preauthorization Required
  • No Annual Limits or Deductibles
  • No Waiting Periods or Pre-Existing Exclusions

Membership Dues

  • First Time Member                                               $380
  • Each First Time Additional Family Member         $330
  • Existing Member                                                   $350
  • Each Existing Additional Family Member            $310

(All family members must reside in the same household) 

Terms and Limitations of the Plan

  • Effective date is the date signed up and renewal date is 12 months from said sign-up date
  • This is a dental discount plan. This is not dental insurance. It cannot be combined with any dental insurance or other offers
  • This plan is only good at Patelzick Family Dental. If you are referred to a specialist they will not offer this discount.
  • Emergency visits are not covered.
  • Rates are subject to change annually
  • Should there be any dental treatment needed following any type of injury where a lawsuit and therefore outside medical care or workers comp insurance are involved, this discount plan cannot be used.
  • This is non-transferable. Family members cannot be substituted in for another.
  • This plan is non-refundable. No refunds are given if patient does not use the entire plan value.
  • Payments for services not covered at 100% are due at time of service. If patient pays using Care Credit the discount is reduced to 5% due to merchant fees.
  • A fee will be incurred for each broken appointment without 24 hours advanced notice.
  • Discount does not apply to products.

Click here to download pdf form.
Give Us A Call: (805) 482-1558