In Office Dental Plan

No Insurance? No Problem!

We are pleased to offer our In-office Dental Plan to our many patients who do not have dental insurance. This program will decrease cost to patients while providing the dental treatment they need.

ADVANTAGES

• No waiting period

• No insurance payment hassles

• No maximum insurance coverage

• No claim forms

• No Pre-Authorizations

• No Pre-Existing Exclusions

YEARLY BENEFITS

• Two dental examinations

• Two dental cleanings(excludes root planing, periodontal medications or non- routine hygiene treatment)

• Routine x-rays including a full series of x-rays every 5 years (Panorex excluded)

• Fluoride treatment for children 12 years and under(Limited to two fluoride treatments/year)

• 10% off dental services provided by Rocklin Family Dental Group including Invisalign

ENROLLMENT FEES/YEAR

• Adult $299

• Child $299

ADDITIONAL INFORMATION

• Enrollment fees are nonrefundable

• Payment is due at or before time of service

• If services are received but not paid for at time of treatment, services will be billed at the usual higher fee

• Patients are eligible immediately upon payment of the enrollment fee. End date is typically 1 year from enrollment date.

• Dental services at specialists (oral surgeons, endodontists, periodontists, orthodontists, etc.) are NOT covered, even if we referred the patient to a specialist. Otherwise, all dental services provided by Rocklin Family Dental Group are included.

• In-office lnvisalign and In-office orthodontics 10% discount.

• If a patient decides to use their dental insurance, the dental insurance deductibles, annual maximums, patient co-payments, and dental insurance payments will apply. The Rocklin Family Dental Group In-Office Dental Plan will not apply in these cases.

• If the patient decides to use CareCredit or Lending Club to pay for dental services, the discount will be 5% due to CareCredit fees.

• Rocklin Family Dental Group reserves the right to change the plan as needed.

• Excludes dental treatment already in progress.

• This offer cannot be combined with any other offers.

Perio In-Office Dental Plan

No Insurance? No Problem!

We are pleased to offer our Perio In-office Dental Plan to our many patients who do not have dental insurance.

This program will decrease cost to patients while providing the dental treatment they need.

ADDITIONAL INFORMATION

• Enrollment fees are nonrefundable

• Payment is due at or before time of service

• If services are received but not paid for at time of treatment, services will be billed at the usual higher fee

• Patients are eligible immediately upon payment of the enrollment fee. End date is typically 1 year from enrollment date.

• Dental services at specialists (oral surgeons, endodontists, periodontists, orthodontists, etc.) are NOT covered, even if we referred the patient to a specialist. Otherwise, all dental services provided by Rocklin Family Dental Group are included.

• In-office Invisalign and In-office orthodontics 10% discount.

• If a patient decides to use their dental insurance, the dental insurance deductibles, annual maximums, patient co-payments, and dental insurance payments will apply. The Rocklin Family Dental Group In-Office Dental Plan will not apply in these cases.

• If the patient decides to use Care Credit or Lending Club to pay for dental services, the discount will be 5% due to Care Credit fees.

• Rocklin Family Dental Group reserves the right to change the plan as needed.

• Excludes dental treatment already in progress.

• This offer cannot be combined with any other offers.