Program Guidelines

• Patient portion of bill is due at time of scheduling.
• Program cannot be used in conjunction with another dental plan or dental insurance.
• No refunds of premiums will be issued if participant decides not to utilize dental plan
• A digital membership card will be provided upon sign up. The card will be sent to your email. Your plan's effective date will also be on file in our office.
• Program cannot be used at any office other than My Best Smile and its providers.
• Program cannot be used for referral to specialists or for hospital care. Plan cannot be used for costs of dental care which is covered under automobile medical.
• Program cannot be used for injuries covered under workers' compensation claim.
• Program cannot be used for treatment for which, in the sole opinion of our doctors, lies outside the realm of their capability.
• Family Plan includes parents and children under 26 years of age.

My Best Smile Advantage Program Limitations and Exclusions

• Demonstrated non-compliance with patient's recommended course of treatment
• Dispensing of drugs not normally supplied in our dental office
• Hospital benefits for any dental procedure
• Loss or theft of dentures or bridgework
• Implantation
• Experimental procedures
• Services for injuries or conditions which are covered under Worker's Compensation or Employer's Liability laws
• Services which are provided without cost to the member by any municipality, county or other political subdivision
• Services that cannot be performed because of the general health, physical or psychological limitations of the patient
• Periodontics, endodontics, oral surgery or pedodontics requiring the services of a nonparticipating dentist/specialist outside of our office
• Those procedures requiring appliances or restorations that are necessary for full mouth rehabilitation, or to alter, restore or maintain occlusion, including, with limitation, treatment of disturbances of the temporomandibular joint
• Procedures performed in the hospital
• Membership fees are due payable, in full, at time of services and are not refundable when any treatment provided equals or exceeds the costs of the membership fee
• All payment for services are due in full at time of services in order to receive Advantage Program savings
• Advantage Program is offered to patients without dental insurance and to those without PPO based insurance program(s) (please ask if you are unsure if you are on a PPO based carrier)
• Advantage Program Participants cannot use insurance benefits or any other dental coverage in conjunction with their Advantage Program membership
• Interest-free payment plans duration may be available upon request with approved credit.
• Repayment duration is based on service totals and procedural type. If you choose to use a repayment plan, your Advantage Program Member Savings and interest free payment options will be customized for your repayment needs.

Eligible family members include spouse and dependent children to age 26 residing in the same household. All Advantage Program Membership fees are due payable at the time of registration are non-refundable after 30 days or once discounts have been claimed. Plan duration is for one year from registration date. All patient portions for services received are due at the time of services in order to receive Advantage Program Benefits. Your anniversary date is your date of initially enrolling in the My Smile Advantage Program. You will automatically be billed each year for your plan on your anniversary date. To cancel your membership you must provide a written request to the office before your anniversary date to stop autorenewal.