VIP 5 Star Discount Plan
It’s better than most commercial dental insurance.
Designed exclusively for those without dental insurance…to provide affordability and greater access to quality dental care.
BENEFITS:
With your Discount & Savings Plan there are :
- No annual maximums
- No deductibles
- No claim forms
- No waiting periods
- No pre-existing condition exclusions or limitations
- No pre-authorization requirements
Benefits Start Immediately
Enrollment
Annual Premium
| Single Adult | $219 |
| Dual (Couple) | $427 |
| Family (3) | $624 |
| Family (4) | $821 |
Each additional family member
$107
You will not receive a membership card. Your effective date will be on file with our office
Benefits:
What’s Covered
Treatment Discount
Diagnostic Services
Comprehensive Exams
| (new patient-initial visit) | 100% |
| Periodic Exam (2 per year) | 100% |
| Limited (emergency) Exam | 100% |
| Panoramic x ray (1 per year) | 100% |
| Single x rays | 100% |
Preventative Services
| Child Prophylaxis | |
| 2 cleanings per year | 100% |
| Adult Prophylaxis | |
| 2 cleanings per year | 100% |
| Additional routine cleanings | 25% |
| Fluoride (2 per year children < 16) | 100% |
| Sealants | 25% |
Other Procedures
| Bleaching (whitening) | 10% |
| Cosmetic Fillings | 25% |
| Crowns | 25% |
| Veneers | 25% |
| Dentures & Partials | 25% |
| Extractions | 25% |
| Sealants | 25% |
| Oral Surgery | 25% |
| Root Canals | 25% |
| Scaling & Root planning | 25% |
| Periodontal Maintenance | 50% |
***If diagnosed with Periodontal disease
You will need 4 periodontal maintenance cleanings a year.
Terms of Usage Program and Limitations & Disclosures
This program is a discount plan-it is not a dental insurance. The plan is only available to individuals that don’t have dental insurance. It cannot be used
- In conjunction with any insurance plan
- For services covered by workmans comp
- For services covered by any other medical or dental insurance
Program Guidelines
- This plan is honored only at VIP Dental Center in Palm Harbor Florida or Dental Emergency Room Clearwater
- Patients’ portion of fee is due at time of service or treatment
- No refunds of premiums will be issued at anytime if participant chooses not to utilize this discount plan.
