Delta Dental for Individuals and Families
STEP 1: Review Plan Benefits
Patient Direct - Plan Summary
The Delta Dental
Patient Direct
Discount Plan has contracted with both general and specialty dentists to deliver quality dental care services at reasonable and predictable prices. Additional plan highlights include:
- No Waiting Periods on Any Services
- No Annual Maximums on Services
- No Deductibles
- Low Monthly Cost
- Significant discounts given by Patient Direct Dentists
- Discounts on Orthodontics and dental specialists
- Locations Throughout Colorado
The Delta Dental
Patient Direct
Discount Plan emphasizes prevention, early detection and dental health maintenance. The summary below provides you with the sample fees, a sample of the discounts you will receive by becoming a member of the
Patient Direct
Dental Plan. Flexible payment options are available.
How much will you save with
Patient Direct
? |
| Sample Savings - AVERAGE
SAVINGS OVER 50%* |
| Services |
Normal Fee |
Your Cost |
Approximate Savings |
| Prophylaxis- Adult Cleaning (Every 6 months) |
$96.00 |
$18.00 |
81% |
| Comprehensive Oral Evaluation-New or Current
Patient |
$97.00 |
$12.00 |
87% |
| X-Rays-Bitewing-4 Films |
$68.00 |
$0.00 |
100% |
| Amalgam Filling - 1 Surface
Primary or Permanent |
$150.00 |
$40.00 |
73% |
| Porcelain Crown Fused to High Noble Metal |
$1164.00 |
$399.00 |
66% |
| Root Canal Therapy 3 Canals or More |
$1058.00 |
$416.00 |
61% |
| Complete Denture-Maxillary |
$1799.00 |
$563.00 |
69% |
| Braces - Children & Adult - 25 Month
Treatment |
$5158.00 |
$4053.00 |
21% |
| *Actual normal fees, your costs, and savings may vary. Please Contact Us with any questions. |
|
Current Dental Terminology© American
Dental Association |
| |
What is the low monthly cost for you to participate? |
| Sample Fees |
Monthly Bank Draft |
Quarterly Pmt |
Annual Pmt |
| Member |
$14.25 |
$42.75 |
$171.00 |
| Member & 1 Dependent |
$25.25 |
$75.75 |
$303.00 |
| Member & 2 or more Dependents |
$36.25 |
$108.75 |
$435.00 |
Rates are
good until your renewal in 2011 |
Continue to STEP 2 Review Dentists |
Patient Direct
Disclosures: |
- I agree to remain in the Delta Dental
Patient Direct
® plan for a minimum of one year. If I terminate my Patient Direct membership I understand that any service provided to me thereafter will not be discounted.
- I understand that discounts offered through
Patient Direct
are only available from Delta Dental
Patient Direct
® dentists. I am aware that dental specialists are not available in all areas.
- I understand that this is a discount plan and that it is not an insurance product.
- I will make all payments to the Delta Dental
Patient Direct
participating dentist at the time services are rendered.
- I have received a copy of the Full schedule of Benefits and exclusions offered by the Delta Dental
Patient Direct
Discount Plan.
- I hold Delta Dental blameless for any harm or loss arising from services or omission of services by the providing dentist and dental office staff.
- Delta Dental of Colorado is the Administrator for the Delta Dental
Patient Direct
Discount Plan.
- I understand that I am continuously enrolled in this plan until I cancel my coverage. To cancel I must notify Delta Dental of Colorado in writing 30 days in advance and will be responsible for any insufficient charges.
- Premiums quoted include an 8% broker commission. Premiums will not differ if you purchase through a broker, or directly through Delta Dental.
|
Full
Schedule of Benefits