Dental Source

 

Plan E

 

Presented by

PBA, Inc.

 

 

 

1-800-578-2082

                                                                       

 

                                                                                                10/00

No Charge Services

·         X-Rays

·         Routine Cleanings

·         Topical Fluoride

·         Oral Exams

·         Local Anesthesia

·         All other dental procedures are covered at a substantial savings to you.  See the benefits schedule on the other side.

 

No Claim Forms

·         The dentist is prepaid directly.

·         Most routine and preventive care is covered.

 

No Deductible

 

Most Pre-existing Conditions are Covered Immediately

 

Large, Established Dental Network

·         You choose your family general dentist from the provider list.

·         Each dentist is licensed and is a skilled, experienced professional.

·         The credentials of each dentist on the provider list are carefully reviewed by American Prepaid before they are selected and are periodically reviewed.

 

No Limit To A Specific Number Of Dental Visits Per Year

 

Easy To Change From One Participating     Dentist To Another

·         All it takes is a phone call to Dental Plans, Inc. at (770) 963-3939 or (800) 578-2082.

 

No Maximum Limitations On Benefits

 

Specialist Care Available

·         A participating specialist will reduce their normal charges by 20% when their treatment is required.

·         Every effort is made to insure a complete range of specialty care in each geographic area but it is not always possible.  Please check with Member Services when in question.

 

No Surprises

·         Check with benefits schedule to know in advance what your co-payment will be for each service rendered.

·         Co-payments are made directly to the dentist.

 

 

 

Dental Source - Plan E

 

Bi-Weekly Payroll Deduction

Individual                                                  $11.00

Individual & one dependent                  $17.00

Family                                                        $21.00

Monthly Bankdraft Rate

Individual                                                  $23.83

Individual & one dependent                  $36.83

Family                                                        $45.50

 

 

 Ask about other plans available:

 

Disability Plan

Permanent Life Plan

Vision Plan

 

  

Please note: This is only a summary of the co-payments and benefits.  For more information on Dental Plans, please call:

1 (800) 578-2082

An Evidence of Coverage will be sent to you upon enrollment.

 

Click here to go to Enrollment Form