House Dental Benefits Plans are available to all uninsured patients. We offer 2 plans to best fit our patient’s needs: Silver plan or Gold plan.

Silver Plan

Adult $375 per year

Child $198 per year

2 cleanings (regular or periodontal)

Periodic Exam once per benefit year

Annual Bitewing x-rays once per benefit year
(FMX for new patients)

Fluoride once per benefit year (twice per year for children)

Oral Cancer Screening

Oral Hygiene Instruction

TMJ Screening

Periodontal Evaluation

One Problem Focused Exam

15% off additional cleanings

20% Off Treatment*:

No cosmetic restrictions

Gold Plan

Adult $495 per year

2 cleanings (regular or periodontal)

Periodic Exam twice per benefit year

Annual Bitewing x-rays once per benefit year
(FMX for new patients)

Fluoride twice per benefit year

Oral Cancer Screening

Oral Hygiene Instruction

TMJ Screening

Periodontal Evaluation

Two Problem Focused Exam with 1 X-Rays (if needed)

$100 credit towards restorative treatment**

25% off additional cleanings

25% Off Restorative Treatment*:

No cosmetic restrictions

Terms:
Coverage is in effect for one year. Coverage begins when membership has been paid in full.

Members will be notified approximately one month prior to membership expiration.

Renewed plans effective date will be the date the previous plan expired.

Patients on the Silver plan can upgrade to the Gold plan at any time for the remainder of the original plan. Gold plans cannot be downgraded to Silver plans.

If a patient cancels the plan prior to using any benefits, a full refund will be issued. Once the plan benefits have been used, no refund will be given.

*Discount on treatment are not applied to specials or products such as ClinPro, electric toothbrushes, brush heads or whitening gel refills. These products are sold at or close to cost.

**Gold Plan credit applicable to treatment of $250 or more. Not applicable to products such as ClinPro, electric toothbrushes, brush heads or whitening gel refills. These products are sold at or close to cost. Credit can be applied to specials.

This is not insurance, cannot be combined with dental insurance and is not transferable to any other office.

Dr. Hillery and his team have reviewed my In-House Benefits Policy. I have had the opportunity to ask questions and I fully understand my policy.

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