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Your Personal Dental Plan by 
What does the plan feature?
- Low copayments
- Quality network of local dental offices
- Fully disclosed coverages and exact copayments
- Pre-existing condition coverage
- No deductibles, claim forms, waiting periods or maximums
- Orthodontic coverage
How much does it cost?
| |
Monthly |  |
| Subscriber |
$17.75 |
| Subscriber + 1 |
$33.75 |
| Subscriber + 2 |
$43.50 |
| Subscriber + 3 or more dependants |
$53.25 |
How does the plan work?
' prepaid dental plan delivers dental care through a network of privately
owned, neighborhood dental offices. You select a conveniently located participating dentist
who will assess your oral health and outline your treatment plan. Your care then proceeds according to this plan.
Most procedures provided by your dentist will require a copayment as outlined in your Schedule of Covered Services
and Copayments.
Click here for more information and to view a list of partcipating dentists
in your area.
What is a copayment?
A copayment is the amount listed in your Schedule of Covered Services and Copayments that you pay directly to
your participating dentist at the time of service. The copayment varies depending upon
what procedure is performed.
How do I receive dental care?
Simply telephone your selected dental office to verify the hours they are open.
Tell them you are a member of ’  plan
and ask for a convenient appointment time. Your dental office receives a membership eligibility list each month,
so it isn't necessary to have your membership card to make an appointment or receive care!
When does my coverage become effective?
If your application and payment are received before the 20th of the current month, your coverage will begin on the
first day of the following month. If you enroll after the 20th day of the current month, your coverage will begin
on the first day of the second month following your enrollment.
How much do I save?
Look at the following examples to see your savings with .
| ADA Code |
Procedure |
Regular Fee* |
Your Copayment |
Your Savings |
| 120 |
Periodicoral Evaluation |
$42.00 |
$2.00 |
$40.00 |
| 1110 |
Prophylaxis (Cleaning) |
$106.00 |
$20.00 |
$86.00 |
| 210 |
Complete Series X-rays |
$131.00 |
$25.00 |
$106.00 |
| 2150 |
2-Surface Amalgam Filling |
$206.00 |
$47.00 |
$159.00 |
| 3310 |
Root Canal - Anterior Tooth |
$469.00 |
$300.00 |
$169.00 |
| 2750** |
Porcelain Crown |
$1011.00 |
$400.00 |
$611.00 |
| |
TOTAL |
$1,965.00 |
$794.00 |
$1171.00 |
* Regular fees are the averages of the usual and customary fees charged for
each service by the dentists who participate in Dental Health Services' network, based on a
November 2002 survey of all participating dentists. Savings may vary based on actual dental services
needed. We encourage you to contact your current dentist for a fee comparison.
** Patient is responsible for the cost of any laboratory charges.
How do I enroll?
Click here to enroll online now!
You may also click here to download an Enrollment Kit that can be filled out and mailed in.
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E-mail us for more information and a free quote or CALL TOLL FREE
1-800-875-4490 (in the U.S.)
or 1-253-854-0199 (outside the U.S.)
Fax: 1-253-896-9411
Mailing address: Maddock & Associates, 1407 Willow Road E, Suite C, Tacoma, WA 98424
Serving all of Washington at 800-875-4490, Seattle at 206-682-1628,
Bellevue at 425-454-6834, Kent at 253-854-0199 and Tacoma at 253-572-3291.
Copyright© 1998-2008, Maddock & Associates | Privacy Statement
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