WILMETTE FAMILY DENTAL
THREE MEMBERSHIP PLANS

SILVER

$400 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

$500 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

$600 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