|
| • | No yearly maximums |
| • | No deductibles |
| • | No claim forms |
| • | No pre-authorization requirements |
| • | No pre-existing condition limitations |
| • | Immediate eligibility with no waiting period |
Total Annual Cost
(savings of $78 off our normal fees)
Total Annual Cost
(savings of $78 off our normal fees)
Total Annual Cost
(savings of $106 off our normal fees)
Total Annual Cost
(savings of $106 off our normal fees)
Total Annual Cost
(savings of $300 off our normal fees)
Total Annual Cost
(savings of $300 off our normal fees)
Total Annual Cost
(savings of $518 off our normal fees)
Total Annual Cost
(savings of $518 off our normal fees)
| • | 2 Exams |
| • | 2 Oral Cancer Screenings |
| • | 2 Fluoride Treatments |
| • | 4 Bitewing X-rays |
| • | Full Mouth Series of X-rays or Panorex |
| • | 15% Off Fillings, Root Canals, Bridges, Crowns, Veneers, Dentures, Partial Dentures, Sealants, Additional Cleanings, X-rays and Exams |
| • | 2 Cleanings (Prophylaxis or Periodontic Maintenance) |
| • | Comprehensive/Periodontic/Limited Exam(2 Per Year) |
| • | 4 Bitewing X-Rays (One Per Year) |
| • | Full Month Series/X-Rays/Panorex (One Every 3 Years) |
| • | Adult Prophylaxis (Two Cleanings Per Year) |
| • | Child Prophylaxis (Two Cleanings Per Year) |
| • | Periodontal Maintenance (Two Per Year) |
| • | Fluoride (Two Per Year – No Age Limit) |
| • | Oral Cancer Screenings (Two Per Year) |
| • | Additional Cleanings |
| • | Additional X-Rays |
| • | Additional Exams |
| • | Dental Sealants |
| • | Fillings & Core Buildups |
| • | Oral Surgery |
| • | Periodontics |
| • | Root Canals |
| • | Crowns/Veneers |
| • | Bridges |
| • | Dentures & Partials |
| • | This contract is only for services performed by the doctors or a staff member of Star City Dental. |
| • | This contract does not replace, eliminate or modify any other contract with Star City Dental. |
| • | Family members must live in the same household as the contract holder (unless attending college), are limited to immediate family members (parents and children), and are included in the family option up to the age of 20. |
| • | This contract does not give discounts on services already rendered. |
| • | Maximum allowed discount off any single procedure is $500. |
| • | Payment must be made at time of service. |
| • | Cannot be used or combined with any other discount or promotion. |
| • | No refunds of premiums will be issued at any time if participant decides not to utilize plan. |
Star City DentalDr. Melanie Fulton Dr. Meghan Hungerford (402) 858-05254525 S. 86th Street, #A, Lincoln, NE 68526-9277 |
Our Dental Savings Program is designed to provide access to affordable, quality dental care.