Dental Membership Plans

Sundrop Dental Membership Program is not insurance. This program is offered to individuals and families who do not have insurance, or who choose not to utilize their insurance at Sundrop Dental Clinic. Dental Membership Program benefits cannot be transferred to another dental practice or dental specialty practice. Payment is always due at the time of service.

• Membership is for one year beginning on the enrollment date.

• Cash, check or credit card payments accepted.

• Membership will not automatically renew on the anniversary date.

• Membership fee will not change during the 12 months of your membership.

• Member will be informed of any increase in annual membership fee prior to renewal.

• Members are responsible for notifying Sundrop Dental Clinic of any address or contact changes.

• Sundrop Dental Clinic may terminate the membership by written notice to the patient if Sundrop Dental Clinic is terminating the doctor patient relationship or discontinuing the membership program.

• Membership benefits are not transferable, have no cash value and may not be redeemed for cash.

• This is not an insurance plan and is not subject to regulation by the state department of insurance.

• Plan membership cannot be combined with current dental insurance plans.

• No insurance claim will be filed for Members under this plan.

• The plan is for individual use only. It is not a group benefit plan.

• Member is responsible for all payments for additional dental services.

• Additional dental service fee will be based upon the fee at the date of service.

• Full payment is due on the date of service to qualify for the discounts offered on the plan benefits list.

• Membership must be current to receive the discounts offered on the plan benefits list.

• Fees for dental services may change at any time.

• It is the member’s responsibility to schedule and keep all appointments offered as part of the Dental Membership Plan.

• Please notify our office at least 48 hours in advance if you must change a scheduled appointment.

• No deductibles, no pre-authorizations, no yearly maximums, no waiting period.

• No exclusions for elective care.

Disclaimer: This agreement does not provide health insurance coverage, including the minimal essential coverage required by applicable federal law. It provides only the services described herein. It is recommended that health care insurance be obtained to cover dental services not provided for under this in-office membership care agreement.