Discount Plan

AQUARIUS DENTAL
In-House Dental Plan for 2019



Examinations/Xrays/ cleanings

Includes your initial and six month recall prophy package of xrays, prophylaxis, exam and fluoride fully covered.

Everything Else

All minor treatments are given a 20% discount. Most major treatments are given a 15%. Major treatments include crowns, partials, dentures and anything over $500. 10% off Implants and orthodontic treatments.

  • Periodontal Therapy/Scaling & Root Planning Procedures
  • Fillings
  • Crowns, Bridges
  • Cosmetic Dentistry
  • Root Canals
  • Extractions
  • Dentures & Partials
  • Scaling and Root Planing (deep cleaning)
  • Emergency exam

MEMBERSHIP DUES:

  • Prices are figured at a yearly rate, and are as follows:
  • Adult family member over 21 years old: $300.00 each
  • Member under 21 years old: $ 250.00 each

BENEFITS OF MEMBERSHIP

  • No preauthorization required
  • No annual maximum. No deductible
  • No waiting periods or pre-existing exclusions
  • Cosmetic dentistry is included
  • Free consults on orthodontic treatment and implants

TERMS AND LIMITATIONS OF THE PLAN:

Your effective date is the day you sign up and your renewal date is the same date every year.

Cleanings must be performed before the end coverage date. The cleaning included with the discount plan is the regular prophylaxis in the absence of gum disease. More serious conditions require deep cleanings with a 20% discount.

This is a dental discount plan and is NOT dental insurance. It cannot be combined with any other dental insurance

Co-payment is due at time of service for any work received

Rates are subject to change annually

Must remain a member during entire duration of orthodontic treatment

Membership dues are not refundable

Discount is only valid at Aquarius Dental


In House Dental Consent Form

Patient Name ______________

Date ____________

Signature _________

In House Insurance Form

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