Welcome to Golden Hill Family Dentistry

About the Plan

Smile with Grace Dental Savings Plan is designed to provide affordability and greater access to quality dental care for those without insurance.
With our plan, there are:

• No yearly maximums

• No deductibles

• No claim forms

• No pre-authorization requirements

• No pre-existing condition limitations

• Immediate eligibility

• No waiting periods

• No denials

• No delays
   

Annual Premiums

Adult: $480 (equal to $40/month)
Child: $360 (equal to $30/month)

• A child is considered under the age of 13.
• The full premium must be paid on the day dental care begins, as monthly payments are NOT allowed.
• The plan will terminate one year from the start date.
• Annual Premiums are subject to annual revisions.
• Next preventative care visits must be scheduled.
• If you do not complete your preventative visits within the year you will not receive a credit
• If any appointment is missed or cancelled within 48 hours there will be a $75 fee per scheduled hour.

Coverage Table

Diagnostic and Preventative – 100% Covered

• Comprehensive Exam (new patient)

• 2 Periodic Exams

• 1 Limited Exam

• 1 Full Mouth X-rays (1 every 3 years)

• Additional X-rays (excludes 3D x-rays)

• 2 Cleanings

• 2 Fluoride Treatments

Covered Services – 15% Discount

• Fillings

• Crowns, Inlays, Onlays

• Periodontics

• Dentures & Partials

• Oral Surgery

• Root Canals

• Orthodontics

• Sleep Apnea Therapy

• TMJ Therapy

Non-Covered Services

• Products

• Whitening

• Some Lab Fees
  
  All plans save you over 40% on diagnostic and preventative care.
   

Plan Exclusions & Limitations

This is a savings plan, not a dental insurance plan
It CANNOT be used:

• In conjunction with another dental insurance plan
• For treatment which, in sole opinion of the treating dentist, lies outside the realm of their capability
• For referrals to specialists
• For hospitalization or hospital charges of any kind
• For costs of dental care which is covered under automobile or medical insurance
• For services for injuries covered under workers' compensation

This plan is only honored at Golden Hill Family Dentistry. This plan is not an insurance plan that can be used at any other dental office. Patient's portion of bill is due on the day of service. Benefit fee table is subject to annual revision.

Periodontal Plan

Covered at 100%

• 1 Comprehensive exam
• 1-2 Periodic Exams
• 4 Periodontal maintenance cleanings
• 4 Laser therapies
• 1 Full Mouth X-rays (1 every 3 years)
• Additional X-rays (excludes 3D x-rays)
• 2 Fluoride Treatments
  
  Annual Premium: $860
  Fee does not include cost of initial periodontal therapy AKA deep cleaning