General Dentistry in Massillon

MASSILLON SMILES DENTAL PLAN

 

WHAT IS THE MASSILLON SMILE DENTAL PLAN?

The MASSILLON SMILES DENTAL PLAN is an annual plan that has been developed to deliver quality dental care services to families like yours…at prices that make sense for today’s economy. Our office offers the convenience of extended hours…plus the individualized attention of private care.

 

MASSILLON SMILES DENTAL PLAN is a discount dental plan run by General Dentistry in Massillon,  to help promote good dental health... while making quality family dentistry more affordable!

  • No Waiting Period - Immediate Treatment
  • Quality Care for Adults and Children
  • No Benefit Limitations

WHERE ARE SERVICES OBTAINED?

Services for this plan are offered at our office only, which is located at 711 Lincoln Way East in Massillon.

 

HOW DO I RECEIVE CARE?

After your membership is effective simply call the dental office for an appointment. Our office offers hours on:

MON & THURS        8:00AM-7:00PM                       FRI      8:00AM-5:00PM

TUES & WED            8:00AM-6:00PM                       SAT     8:00AM-2:00PM

 

WHO IS ELIGIBLE?

You, your spouse and any dependent children under the age of 19 or full-time students up to age 23 years of age (proof must be provided).

 

WHEN WILL BENEFITS BEGIN?

Benefits will begin immediately. Members must remain in the plan for a minimum of 12 months.

 

WHAT IS THE ANNUAL COST?

Member

$175.00

Member+1

$250.00

Member+2 or 3

$350.00

Member+3 or 4

$425.00

 

 

 

WHAT ARE THE BENEFITS?

The MASSILLON SMILES DENTAL PLAN provides simple teeth cleanings (up to 2 per year), Examinations and x-rays at NO CHARGE. Your membership in this plan also affords you a reduced fee schedule. However, unlike a conventional insurance plan there are no deductibles and no yearly maximums. Additional comprehensive treatment or procedures are provided at REDUCED rates of 20% OFF.   Cosmetic tooth whitening is also covered  with the MASSILLON SMILES DENTAL PLAN at a reduced fee:   There is a $20.00 copay that will be due on problem oriented office visits.  There is also a charge of $20.00 for broken appointments.  

 

Patient PaymentsAll payments are made directly to the dental office. As treatment is performed payments are made at each appointment. You should discuss all future payments and costs before new appointments are made. Interest free PAYMENT PLANS are available to cover the cost of treatment for 3, 6 and 12 months with approved credit (repayment length is based on amount of service). When a payment plan is used the amount of the discount given is only 10%.

 

Emergency Care

Eligible members and their eligible dependents may receive emergency care for the relief of pain or swelling from any dentist in our facility when their plan dentist is unavailable. There will be a $20.00 copay due on these visits.

 

How To Join

Fill out the attached enrollment form; include your check or credit card information and the number of family members that will be joining the plan.

 

 

LIMITATIONS & EXCLUSIONS

1.       Demonstrated non-compliance with the recommended course of treatment

2.       Services which in the opinion of the attending dentist are neither necessary nor recommended for the patient’s health.

3.       Restorations, splints or other appliances used to increase vertical dimension or restore occlusion

4.       Any service you a re referred out of the office for, Periodontics, Endodontics, Oral Surgery.

5.       Congenital malformations, except congenital anomaly of a tooth or teeth covered from birth.

6.       Dispensing of drugs not normally supplied in the dental office.

7.       Hospital benefits for any dental procedure.

8.       Loss or theft of dentures or bridge or crowns.

9.       Services for injuries or conditions which are covered under Workers’ Compensation or Employer’s Liability Laws.

10.   Services that cannot be performed because of general health, physical or psychological limitations of the patient.

 

 

SERVICE FOR THIS PLAN AVAILABLE AT:

 

General Dentistry In Massillon

711 Lincoln Way East

Massillon, Ohio 44646

 

PROVIDERS FOR THIS PLAN ARE:

J. Douglas Paulus, D.D.S.

Shaun P. Doherty D.D.S

General Dentists

 

Enrollment Form

 

Last Name _________________First_________________ MI ______

 

Home Address ____________________________________________

 

City _______________________ State __________ Zip ___________

 

Home Phone _________________ Work Phone __________________

 

Birth date ___/___/___ Employer ______________________________

 

List Covered Dependents

 

             Name                                                                                            Birth date                     Relationship

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Payment Method:

 

Annual Payment

_____ Check Enclosed: $___________

_____ Card # ___________________________

           Exp. Date _____/_____

           Card Type: Visa/MC/Discover/American Express (circle one)

            Signature _____________________________________

 

Please read and sign below:

 

I understand the benefits, limitations, exclusions and requirements of the Massillon Smiles Dental Plan and I agree to the following.

1.       I will remain in the plan and pay membership fees for a minimum of 12 months.

2.       Payment of less than 12 months membership fees may cause me to be charged the usual and customary fees for all services (including those already provided) and my being charged for the remaining months fees in lump sum.

3.       Fees for dental services are due when services are rendered.

4.       Fees for prosthodontic and cast restorations are due at the preparation/impression visit. Failure to comply may result in my being charged usual and customary fees for such services.

5.       I agree to pay any and all costs in collecting all charges, including but not limited to attorney fees and court costs.

 

 

Signature _______________________________________ Date___/___/____

 

Mail this form to:

Massillon Smiles Dental Plan

711 Lincoln Way East

Massillon, Ohio 44646

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home
MassillonSmiles Gold Plan
Meet the Doctors
Dental Health
Cosmetic Dentistry
Advanced Services
FAQ
Hours
Payment
Map and Directions
Out of Town Dentists

Dental Education
Patient Feedback
Contact Us