What is a 
prepaid
dental plan?
'
prepaid dental plans deliver dental care through a network of
privately owned, neighborhood dental offices. You select a
conveniently located participating provider 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.
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 provider 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 Smart
Smile plan
-and ask for a convenient appointment time.
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.
| Monthly Rates |
Smart Smile |
|
| |
Monthly |
Annual |
| Subscriber: |
$17.75 |
$213.00 |
| Subscriber plus 1: |
$33.75 |
$405.00 |
| Subscriber plus 2: |
$43.50 |
$522.00 |
| Subscriber plus 3 (or
more): |
$53.25 |
$639.00 |
What Does My Plan Cover?
Who Are
The Plan Providers?
How does the plan work?
How Do I Receive
Dental Care?
When does
my coverage become effective?
How much do I save?
Print
Application
To Enroll simply
print
out an application and complete it, enclose first months premium payment and mail to;
Dental
Health Services
936 N 34th St
Suite 208 Seattle, WA 98103
Apply Online Now!
How
does the plan work?
The 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.
To
Receive Dental Care
Simply telephone your selected dental office and introduce yourself.
Tell them you are a member of Dental Health Services Smart Smile
plan and ask for a convenient appointment time.
Coverage Becomes 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 |
Periodic oral evaluation |
$42.00 |
$5.00 |
$37.00 |
|
1110 |
Prophylaxis (cleaning) |
$84.00 |
$20.00 |
$64.00 |
|
210 |
Complete series x-rays |
$91.00 |
$20.00 |
$71.00 |
|
2150 |
Two-surface amalgam filling |
$115.00 |
$45.00 |
$70.00 |
|
3310 |
Root canal - anterior tooth |
$469.00 |
$275.00 |
$194.00 |
|
2750** |
Porcelain crown |
$769.00 |
$400.00 |
$369.00 |
| |
TOTAL |
$1,570.00 |
$765.00 |
$805.00 |