WILMETTE FAMILY DENTAL
SILVER
$500 Annually
- 10% discount on all other services
- 2 cleanings per year (prophylaxis and exam)
- Unlimited digital x-rays
- Unlimited consultations and emergency visits
(MAINTENANCE VALUE OF $702)
GOLD
$650 Annually
- 15% discount on all other services
- 3 cleanings per year (prophylaxis, periodontal and exam)
- Unlimited digital x-rays
- Unlimited consultations and emergency visits
(MAINTENANCE VALUE OF $867)
PLATINUM
$795 Annually
- 20% discount on all other services
- 4 cleanings per year (prophylaxis, periodontal and exam)
- Unlimited digital x-rays
- Unlimited consultations and emergency visits
(MAINTENANCE VALUE OF $1032)
Guidelines
- Enrollment date begins on the date enrollment fee is paid and expires after 365 days
- Annual enrollment fees are due at the time of enrollment
- Valid with health savings accounts, flex spending accounts, and health reimbursement accounts
- All plans are available on an individual basis for each family member
- All membership fees are non-refundable
- All additional charges are due day or service
- 24 hour cancellation is required for all types of dental cleanings otherwise appointment is forfeited
Exclusions and Limitations
- Strictly valid only at our office
- Not valid with coexisting dental insurances or benefits
- Our program is not transferable to another party or uncovered family member
- Does not cover any portion of a specialists referral
- Not applicable to hospitalization or hospital charges of any kind
- Will not apply to dental care for injuries covered under worker’s compensation
- Will not apply to dental care for which, in sole opinion of the treating dentist or doctor, lies outside the realm of their capability
- Not valid on fluoride, Arestin®, products (electric toothbrush, Waterpik) or prescriptions
- Excludes SureSmile® and orthodontic treatments
*this is not dental insurance