The Walnut Street Smiles Savings Plan is designed to provide greater access to quality dental care at an affordable price.
It's a discounted fee schedule for dental services provided at Walnut Street Smiles for those without insurance. It is not a dental insurance plan.
Our membership program is an annual reduced-fee savings plan for families and individuals that allows its members to receive quality dental services at greatly reduced prices.
Unlike conventional insurance plans, with the Walnut Street Smiles Savings Plan there are no deductibles, no yearly maximums, and no waiting periods to begin treatment. The membership program benefits coverage begins immediately on plan registration.
Our Savings Program Benefits include:
- 2 Simple Teeth Cleanings
- 2 Dental Exams During Cleaning Visits
- All Necessary X-rays During Cleaning Visits
- 1 Emergency Exam
- 2 Fluoride Treatment
- 1 AirFlow Therapy per year
- Oral Cancer Screening
- Professional whitening, including custom trays
- 20% Savings on Restoratives (includes composite fillings, simple extractions and root canals)
- 20% Savings on Major Dental Procedures (includes crowns, dentures, partials, periodontal and surgical services)
- 20% Savings on Dental Implants
Additional family members can join at a reduced rate, providing even more savings. If you currently pay $50 or more per month for yourself/spouse/dependents to receive dental benefits, our Savings Plan may be a better financial alternative for you and your family.
This is a discount program, not a dental insurance plan.
VIEW PROGRAM GUIDELINES
- The fee paid for our savings plan is for included standard-of-care services and represents a courtesy accounting adjustment for payment, made in full, at the time of service.
- Fees for dental services/treatment are due, in full, at time of service in order to receive the savings.
- Fees for prosthodontic (dentures) and cast restorations (crowns, inlays, onlays, veneers, implants, etc) are due at the prep appointment
- Savings plan fees are not transferrable.
- There are no refunds on your savings plan fee when any services have been rendered.
- Program cannot be used in conjunction with another dental plan or dental insurance.
- No refunds of premiums will be issued if participant decides not to utilize dental plan
- Your plan's effective date will be on file in our office.
- Program cannot be used at any office other than Walnut Street Smiles
- Program cannot be used for referral to specialists or for hospital care. Plan cannot be used for costs of dental care which is covered under automobile medical.
- Program cannot be used for injuries covered under workers' compensation claim.
- Program cannot be used for treatment for which, in the sole opinion of our doctors, lies outside the realm of their capability.
- Free simple cleanings benefits will be applied to the costs of Periodontal Maintenance Fees ( up to 2 applied per year)
Walnut Street Smiles Savings Plan Limitations and Exclusions
- Demonstrated non-compliance with patient's recommended course of treatment
- If you have Periodontal Disease, a Periodontal Maintenance will be performed as a 'simple' cleaning will not be sufficient for your oral health care needs. The simple cleaning benefit, included in the Savings Plan membership, will be applied to the costs of your Periodontal Maintenance cleanings two times in your plan year. The difference in cleaning fees will be your responsibility at the time of service. Each additional recall, we will offer you a savings on your periodontal maintenance cleanings when you pay for them in full at time of service.
- Restoration, splints or other appliances used to increase vertical dimension or restore occlusion
- Oral surgery requiring the setting of fractures or dislocations
- Treatment of malignancies, cysts or neoplasms
- Congenital malformations, except congenital anomaly of a tooth or teeth covered from birth
- Dispensing of drugs not normally supplied in our dental office
- Hospital benefits for any dental procedure
- Loss or theft of dentures or bridgework
- Experimental procedures
- Services for injuries or conditions which are covered under Worker's Compensation or Employer's Liability laws
- Services which are provided without cost to the member by any municipality, county or other political subdivision
- General anesthesia
- Services that cannot be performed because of the general health, physical or psychological limitations of the patient
- Periodontics, endodontics, oral surgery or pedodontics requiring the services of a nonparticipating dentist/specialist outside of our office
- Those procedures requiring appliances or restorations that are necessary for full mouth rehabilitation, or to alter, restore or maintain occlusion, including, with limitation, treatment of disturbances of the temporomandibular joint
- They are not transferable to other program members
- Diagnosis and treatment of myofacial pain dysfunction syndrome
- Procedures performed in the hospital
- Membership fees are due payable, in full, at time of services and are not refundable when any treatment provided equals or exceeds the costs of the membership fee
- All payment for services are due in full at time of services in order to receive Savings Plan member savings
- All members of the same family account have the same anniversary date as the primary member
- Savings Plan is offered to patients without dental insurance and to those without PPO based insurance program(s) (please ask if you are unsure if you are on a PPO based carrier)
- Savings Plan Participants cannot use insurance benefits or any other dental coverage in conjunction with their Savings Plan membership
- Interest-free payment plans duration may be available upon request with approved credit.
- Repayment duration is based on service totals and procedural type. If you choose to use a repayment plan, your Savings Plan Member Savings and interest free payment options will be customized for your repayment needs.
- Unused services, part of the Savings Plan membership program, are not transferable to other patients, to other offices and do not roll over to the next membership year
- A 48 hour notice is required to reschedule and/or cancel appointments or we reserve the option to bill you 25% of the scheduled treatment amount for your missed appointment
Eligible family members include spouse and dependent children to age 19 (under 23 if full time student). All Savings Plan Membership fees are due payable at the time of registration are non-refundable. Plan duration is for one year from registration date. All patient portions for services received are due at the time of services in order to receive Savings Plan Benefits. All members of an Savings Plan family account will have the same anniversary date as the primary member. A missed appointment fee of 25% of treatment total will be charged for all missed dental appointments. Please notify our office at least 48 hours in advance if you must change your appointment.
Please Note: The Savings Plan is subject to Program Guidelines listed here in the description and is offered to patients without dental insurance and to those without PPO based insurance program(s).
TERMS & CONDITIONS
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. This plan is accepted at the dental practice where you purchased the plan. If unused, you may cancel within the first 14 days after receipt of membership materials or the effective date, whichever is later, and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). This plan is not available in Vermont or Washington, Utah.
Note: This plan's benefits are automatically terminated upon your activation of a dental insurance plan.
Renewal Conditions: By joining, you are authorizing the Plan to bill your credit card or checking account. This charge shall renew until you notify the Plan in writing of its cancellation. By joining you indicate you have read the terms and conditions of the Plan. This plan will automatically renew at the end of your membership term, and your credit card or bank account will be automatically charged or drafted for the appropriate amount.
Termination Conditions: MERCHANT and the Plan reserve the right to terminate plan members from its plan for any reason, including non-payment. If the Plan terminates the program or your membership for a reason other than non-payment, you will receive a pro-rata refund of your membership fees.
Cancellation Conditions: You have the right to cancel within 30 days from the effective date and receive a full refund, less the processing fee, if applicable. If for any reason during this time period you are dissatisfied with the Plan and wish to cancel and obtain a refund, you must submit a written cancellation request. The Plan will accept cancellation requests at any time and will stop collecting membership fees in a reasonable amount of time, but no later than 30 days after receiving a cancellation notice. Please send a cancellation letter and a request for refund with your name and member ID to our MERCHANT Address or fax. You may also submit cancellation requests by email. When you cancel, you will continue to have access to the plan for the remainder of the period for which you have paid; your membership will terminate at the end of that period. The preceding sentence does not apply to quarterly, semi-annual or annual memberships in FL, ND and OK, where you will receive a pro-rata refund whenever you cancel.
Description of Services: Please see the product detail page for a specific description of the plan that you have purchased.
Limitations, Exclusions & Exceptions: This plan is offered by MERCHANT. The Plan is not a licensed insurer, health maintenance organization or other underwriter of health care services. No portion of any provider’s fees will be reimbursed or otherwise paid by the Plan. The Plan is not licensed to provide and does not provide medical services or items to individuals. You will receive discounts for services at certain health care providers who have contracted with the plan. You are obligated to pay for all health care services at the time of service. Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific services or products purchased. Please verify such services with each individual provider. The plan’s discounts may not be used in conjunction with any other discount plan or program. All listed or quoted prices are current prices by participating providers and subject to change without notice. Any procedures performed by a non-participating provider are not discounted. From time to time, certain providers may offer products or services to the general public at prices lower than the discounted prices available through this plan. In such event, members will be charged the lowest price. Discounts on professional services are not available where prohibited by law. This plan does not discount all procedures. Providers are subject to change without notice and services may vary in some states. It is the member’s responsibility to verify that the provider participates in the plan. At any time the Plan may substitute a provider network at its sole discretion. The Plan cannot guarantee the continued participation of any provider. If the provider leaves the plan, you will need to select another provider. Providers contracted by the Plan are solely responsible for the professional advice and treatment rendered to members and the Plan disclaims any liability with respect to such matters.
Complaint Procedure: If you would like to file a complaint regarding your plan membership, you must submit your complaint in writing to MERCHANT Address. You have the right to request an appeal if you are dissatisfied with the complaint resolution. After completing the complaint resolution process, if you remain dissatisfied you may contact your state consumer department.
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