AmeriPlan Dental Plan
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Ameriplan USA®
join this plan and get 3 additional benefits added to your program for FREE!
Vision - Rx - Chiropractic |
| Program Membership Fee |
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Family2:
$19.95 per month 1
Call us Toll Free: 1-866-630-4262
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1 Additional one-time $20.00 sign-up fee. Join today and you may begin using your program on .
2 Family plan members include card holder, spouse, dependant children and any permanent resident in the member's household. No age restriction or limit to the number of members in a household.
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| Program Features and Highlights |
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* Actual costs and savings vary by geographic region.
** According to the AmeriPlan USA® Provider Network Database as of 10/1/2005. |
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| How this Low Cost Dental Plan Can Save You Money |
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| AmeriPlan USA® Low Cost Dental Plan
is a discount or reduced-fee dental program. This program is designed for health conscious consumers looking to maintain their oral health and minimize their dental care expenses.
General dentists who participate in the AmeriPlan® Provider Network have agreed to accept the AmeriPlan® Dental Plan
contracted rate as payment in full for services performed. A sample table of AmeriPlan® Dental Plan
discounted fees can be found below. |
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| Sample Discounted Fees and Savings |
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| Procedure Description |
1 Dental Office Fees Up To |
2 AmeriPlan Discounted Fee |
AmeriPlan Member Savings |
| Initial Oral Exam |
$90 |
$25 |
$65 |
| Routine 6 Month Check-Up |
$60 |
$12 |
$48 |
| Intraoral Complete Series X-Rays |
$115 |
$35 |
$80 |
| Panoramic X-Rays |
$100 |
$40 |
$60 |
Regular Teeth Cleaning (Light Scaling & Polishing) |
$95 |
$25 |
$70 |
Deep Teeth Cleaning (Full Mouth Debridement/Removal of heavy tartar buildup) |
$195 |
$75 |
$120 |
Amalgam Filling (Silver Colored) 1 Surface (Primary or Permanent) 2 Surfaces (Primary or Permanent) |
$120 $150 |
$35 $50 |
$85 $100 |
Composite Filling (Tooth Colored) 1 Surface (Anterior) 2 Surfaces (Anterior) |
$150 $185 |
$50 $70 |
$100 $115 |
Root Canal Anterior Bicuspid |
$635 $745 |
$300 $350 |
$335 $395 |
Porcelain Crown w/ High Noble Metal |
$975 |
$475 |
$500 |
Orthodontic Treatment** (Braces) by General Dentist |
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| Children (under Age 19) |
$4500 |
$2000 |
$2500 |
| Adults (19 and over) |
$5000 |
$2200 |
$2800 | | |
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| The sample table above is a small selection of common procedures discounted by AmeriPlan USA®. The procedures discounted under AmeriPlan USA®
offer similar savings to the sample above.
This fee schedule is only to be used as a guide to determine approximate prices for dental services in the geographic area noted. The discounted fee schedule amount reflects the average fee information currently available on our systems. The above fees apply to the major metropolitan areas of: Colorado, Georgia, Illinois, Kansas, Louisiana, Missouri, Oklahoma, Tennessee, Texas and in all areas of Arizona and Hawaii.
Different fees may apply in other areas of the above states. (Rural areas) For the appropriate fees for your area, enter your Zip Code below for participating dentists and their dental service fee schedules.
1 Source: National Dental Advisory Service 2003 | Dental Economics, Annual Dental Fee Survey 2003. Fees may vary slightly by region.
2 Discounted fees are listed for visits to a participating general dentist. Members will be charged the provider's AmeriPlan® Dental Plan contracted fees. Charges may vary from the sample fee schedule above. Consult with your provider prior to beginning any treatment. Lab fees may be additional.
This plan is based geographically by ZIP code in terms of provider participation and location. Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code. |
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| Specialist Savings and Discounts |
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| AmeriPlan® Dental Plan members who visit a participating specialist receive discounts according to the fee schedule. Specialists include:
 | Orthodontists - braces*
|  | Periodontists - gums
|  | Oral Surgeons - wisdom tooth or major extractions
|  | Prosthodontists - bridges and dentures
|  | Pediatric Dentists - child treatment
|  | Endodontist - extensive root canals |
* Invisalign Braces may not be included. Consult with your general dentist or specialist prior to beginning any treatment. |
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| What You Get When You Enroll |
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When you join AmeriPlan® Dental Plan through DentalCareMadeAffordable.com, your membership ID number is provided instantly online upon confirmation from AmeriPlan USA® and you are able to visit the dentist as early as the next day. Simply identify yourself as a member when you make your appointment and your fees will be automatically discounted. You pay the provider at the time of service.
Within 10 to 14 working days of receipt of your application, you will receive
 | Your membership welcome letter
|  | Member Information Guide
 | Instructions and tips for maximizing your savings |
|  | (2) Membership Identification Cards
|  | A complete fee schedule with discounted fees on dental procedures
|  | Dental Care Provider Directory
|  | Vision, Pharmacy and Chiropractic Care Directory
|  | Member Billing and Support Services
|  | 100% Satisfaction Guarantee
|  | 30 Day Cancellation Refund Policy* |
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JOIN THIS PLAN
and get 3 additional benefits added to your program for FREE!
Vision. RX. Chiropractic |
| Availability: |
Nationwide |
| Dentists: |
30,000 |
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Monthly Membership Fee |
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| Family: |
$19.95 per month |
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Have questions before you enroll?
Call us Toll Free: 1-866-630-4262 |
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1 Additional one-time $20.00 sign-up fee. Join today and you may begin using your program on .
2 Family plan members include card holder, spouse, dependant children and any permanent resident in the member's household. No age restriction or limit to the number of members in a household.
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| AmeriPlan Dental Plan Notes |
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This is NOT insurance. Ameriplan USA®: 5700 Democracy Drive, Plano, Texas 75024. This discount card program contains a 100% Satisfaction Guarantee 30 Day Refund Policy.*
You are entitled to choose any participating dentist listed in Ameriplan USA® Provider Directory. Dental offices are located throughout the United States. The dental provider listings on DentalCareMadeAffordable.com are provided directly from the Ameriplan USA® dental network, who are responsible for its accuracy and completeness. These listings are updated on a monthly basis, and every effort has been made to ensure that only participating active providers are listed. We strongly recommend that you confirm that a provider is currently participating before you receive any services from that provider. Please see Member's Disclaimer for more details.
This dental plan is based geographically by ZIP code in terms of provider participating and location. Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code.
* If you use any of your Ameriplan USA® Benefits within the first 30 days of becoming a member, and you are not satisfied, you may cancel your membership in writing to AmeriPlan® Bank and Credit Card Services by mail to 5700 Democracy Drive, Plano, Texas 75024, FAX to (469) 229-4595 or email to stop@stopmembership.com. In order to receive your membership fee refund you must return the membership identification cards. The one-time registration fee and money paid for healthcare services and products are not refundable. After 30 days membership fees are non-refundable. You may cancel your membership at any time by written request and the return of your membership cards. Attempts to cancel by telephone will not be accepted. If you have any questions about this 30 Day Refund Policy please call DCMA Toll Free: 1-866-630-4262

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