No insurance? No worries. With the Foust Family Dental membership plan there are no yearly maximums, no deductibles, no waiting periods, no pre-authorizations, and you are immediately eligible.
| DIAGNOSTIC AND X-RAYS | |
| Comprehensive Exam (new patient, initial visit) | 100% |
| Periodic Exam (2 per year) | 100% |
| Bitewings (yearly as needed) | 100% |
| Panoramic (every 3 years) | 100% |
| PREVENTIVE | |
| Child Prophylaxis (cleaning) (2 per year) | 100% |
| –Additional visits | 20% |
| Adult Prophylaxis (cleaning) (2 per year) | 100% |
| –Additional visits | 20% |
| Fluoride | 20% |
| Sealants | 20% |
| ALL OTHER PROCEDURES | |
| Fillings | 20% |
| Crowns/Bridges | 20% |
| Root Canals | 20% |
| Oral Surgery | 20% |
| Periodontics | 20% |
| Implants | 20% |
| Dentures/Partials | 20% |
| Nitrous Oxide | 20% |
| Whitening | 20% |
| Night Guards | 20% |
Cost of Dental Plan
Single: $340
Couple: $680
Family: $1200
Membership Limitations and Exclusions
The program is a discount plan, not a dental insurance plan and cannot be used:
- In conjunction with dental insurance or another dental plan
- For services or injuries covered under workman’s compensation
- For treatment which, in the sole opinion of the treating dentist, lies outside the realm of their capabilities
- For referral to specialists
- For hospitalization or hospital charges of any kind
- For costs of dental care which are covered under automobile, homeowners, or medical insurance
Program Guidelines
Patient will be charged full membership fee at time of enrollment, all other fees will be due at time of service.
This plan is only honored at Foust Family Dental Care. It cannot be used at any other dental office. The cost of the plan is NON-REFUNDABLE. Plan is subject to change annually.