STATEMENT OF PRIVILEGES AND EXCEPTIONS
CHIARA DENTAL MEMBERSHIP PLAN
Chiara Dental Membership Plan is an annual reduced-fee plan for families and individuals that allows all members to receive quality dental services at substantially reduced prices. Unlike insurance plans, with the Chiara Dental Membership Plan there are no deductibles, no yearly maximums, and no waiting periods to begin treatment. Eligibility for privileges begins immediately upon plan registration.
Privileges of membership include the following services when performed by or at the direction of the attending dentist or dental hygienist at the offices of Chiara Dental:
- Standard teeth cleanings – up to two per year
- Complete annual dental exam
- X-rays for complete annual exam
- Fluoride applications – up to two per year for each member
- Teeth whitening – one treatment of each member per year
- A 30% discount on all other dental procedures
Membership is $347 for an initial plan member and $247 for each additional family member. These amounts may be adjusted for future years.
A missed appointment fee of $50.00 will be charged for all missed dental appointments. Please notify our office 24 hours in advance if you must change a scheduled appointment.
EXCEPTIONS and LIMITATIONS
The following are excluded from Chiara Dental Membership Plan privileges:
- Services that, in the sole judgment of the attending dentist, are not advisable, or are contrary to the patient’s dental condition or health
- Orthodontic services
- Services performed at a hospital, or any location other than the office of Chiara Dental
- Services for injuries or conditions covered under worker’s compensation or employer’s liability insurance.
- Services provided without cost to the member by any municipality, county, state, or government entity
- General anesthesia and conscious sedation
- Any services that, in the sole judgment of the attending dentist, cannot be performed because of the general health, physical, or psychological limitations of patient
- Periodontics, endodontics, oral surgery, or pedodontics that requires the services of a non-participating dentist
- Any procedures performed at any location other than the offices of Chiara Dental, L.L.C., including any procedures at a hospital
Chiara Dental Membership Plan members cannot use dental insurance or other dental coverage in conjunction with this plan. Privileges expire at the end of the patient’s membership year, regardless of when services were scheduled.