Las Cruces Dental Solutions In House Dental Plan

Thank you for your interest in joining our Las Cruces Dental Solutions In House Dental Plan. Annual benefits for the standard plan include 2 cleanings, exams, x-rays, fluoride, and 20% of cosmetic and restorative dentistry. If you choose the premium plan (best for patients with periodontal disease) you will receive an additional 2 cleanings per year.

Additional family members can be registered at a reduced rate after you register the primary account holder.

Here is a breakdown of the pricing:

Standard plan primary account holder – $25/month (12 month commitment)

Premium plan primary account holder – $40/month (12 month commitment)

Each additional family member on standard plan – $15/month (12 month commitment)

Each additional family member on premium plan – $30/month (12 month commitment)

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Terms and Conditions


Overview
The Dental Solutions Dental Savers Plan is a membership program offered at Las Cruces Dental Solutions in which members pay a monthly fee and receive a specific list of services as included benefits, and receive a discount on all other services as listed below. The Dental Solutions Savers Plan is NOT INSURANCE and does not make payments directly to providers of dental services or other servicers offered under this plan. Members are obligated to pay providers for all services received. Members are entitled to pay predetermined fees or fees at a discounted percentage compared to the Dental Solutions standard Fee For Service Fee Schedule or “UCR” Fee schedule. Provider fees and the range of discounts for services provided will vary depending on geographical area, provider type, and services rendered.

Fees
The fee for the individual and family plan are as listed below. The Dental Solutions Dental Savers Standard Individual Plan fee is $25 per month.

Additional family members
Each additional spouse or dependent will have an additional cost of $15 per additional member. 

Children age 4 and under
Children age 4 are under can be seen at no additional charge as long as they are dependents of a primary member of an active Dental Solutions Savers Plan. All children age 5 and above can be added to a plan at the additional family member rate of just $15 per month per section as outlined in this section. 

Premium Plan
The Dental Solutions Dental Savers Premium Plan is an additional upgrade to any individual standard
plan or additional family member’s plan. The Premium plan is designed for members that are being
treated for or have ever been diagnosed with Periodontal disease and require more than the standard 2
prophies (dental cleanings) per year. The Premium Plan includes all of the same benefits as the
Standard Plan with the additional benefit of including up to 4 periodontal maintenance cleanings per year
instead of 2 adult or child prophies per year. The additional cost is $15 per month per individual that is
signed up for Periodontal Premium Plan upgrade.

Standard Plan Outline of Benefits
100% Covered Benefits - The following is an outline of benefits that each active member will receive at no additional cost per 12- month period on the plan.

• 2 child or adult prophylaxis (dental cleanings)
• 2 dental exams (Comprehensive or Periodic depending on need)
• All necessary dental X-rays (excluding CT/Cone Beam and advanced imaging)
• Up to 2 emergency exams
• 2 fluoride varnish treatments
• 2 oral cancer screenings 

Discounted services
Services not covered on the 100% covered benefits list will be given reduced fee schedule which will be a 20% discount from the offices standard fee for services fee schedule or “UCR” fee schedule. 

Premium (Periodontal) Plan Outline of Benefits
The periodontal Plan will have all of the same benefits as listened for the standard plan above with the
exception of the following.

The Periodontal Plan upgrade will make the member eligible for up to 4 periodontal maintenance visits
per year of membership at the 100% covered benefit rate. Members on the periodontal Plan will not be
eligible for standard priories as Thursday will receive periodontal maintenance visits instead.

Term and Cancellation

Initial Term
This agreement will be a 12-month term starting on the initial date of sign up and submission of this contract. The member agrees to have 12 consecutive payments of the amount determined at checkout. The member also agrees to having credit card information stored by an authorized PCI compliant third party vendor. Credit card information will not be maintained by the practice, but solely by the payment processor. The term will renew automatically for an additional 12 months every year on the same date (Renewal Date) as the initial sign up date or the submission date of this agreement. Cancellation requires written notice prior to the renewal date.

Early Termination
Members have the right to cancel within the first 30 days after receipt of membership materials subject to the cancellation policy. Cancellation of membership plan will result in all discounts and included services received while on the plan to be charged out at the standard fee for service fee schedule or “UCR” rate with payment due immediately. The member would be refunded their plan fees minus the amount of discounts received while on the plan. It is possible that the member would owe more than the plan payments to date and would be required to pay those fees immediately in order to terminate the contract
early. The member will be ineligible for termination of the contract without payment of the potential fees resulting from the subtraction of discounts for the first year of membership.

Termination at the end of the agreement
The membership plan can be terminated by providing written notice prior to the annual renewal date.

Termination After the First Year
After the first year, the patient may cancel at any time with written notice 15 days prior to the next scheduled payment date. Any cancellations requested within the 15 day cancellation requirement will result in one last payment being run and cancellation of the membership after that point.

Services After Cancellation
After cancellation, the former member is entitled to no services at the 100% covered benefit or 20% discounted rate. The patient is not entitled to discounted services even if they did not utilize benefits while they were a Member. Benefits are not saved, stored, or maintained outside an active membership period. The patient can continue to be seen at the participating Dental Savers Plan practice location and would be excited to pay the full fee for service fees or UCR fee schedule which would be due at the time of service.