|
1. |
Dental procedures performed
only in the participating dental office are benefits under this plan.
|
|
|
|
2. |
Only procedures listed in
the Fee Schedule are covered. Unlisted procedures may be available
at 80% of provider’s usual fees. Not all dentists perform all
dental procedures.
|
|
|
3. |
Routine cleanings are
limited to one cleaning per six months.
|
|
|
4. |
If a dental emergency
arises, contact your participating dentist as soon as possible.
There are no benefits for out-of-area emergency services.
|
|
|
5. |
Dental providers are
independent contractors and are solely responsible for all treatment
provided. Appleton Dental Plan makes no expressed or implied
warranties regarding services received, and disclaims all liability for
any and all services performed by contracted providers and their
associates.
|
|
|
6. |
Any dental treatment
started prior to the Member’s eligibility to receive benefits under this
plan, or started after a Member’s termination is not covered.
|
|
|
7. |
Accidents that occur
during treatment or the failure to follow the treatment plan could
result in additional fees to the patient.
|
|
|
8. |
This dental program is
NOT an insurance product, but rather a discounted fee dental program.
|
|
