Quality Care Membership Plan
Quality Care Membership is a GREAT program to help save money on your dental visit, if you do NOT have insurance.
• Two Simple Cleanings (does NOT include scaling & root planning)
• Annual Routine x-rays
• Two Clinical Exams
• Annual Fluoride for kids 12 and under
• One Emergency Exam
• 15% Discount on All General Dentistry and Periodontal Treatments at
St. Francisville Family Dentistry (fillings, crowns, bridges, extractions,
root canals, dentures, scaling & root planing)
ages 15+ – $298
ages 0 -4 – $219
Buy any 1 plan (Adult or Child) and receive a 5% discount for any additionaly family members
If you have questions about the membership or would like to join,
please call us 225-635-6554
HOW DO YOU BENEFIT
• No Yearly Maximums!
• No Deductible!
• No Pre Existing Exclusions!
• Gives You Control Of Your Dental Needs.
• Gives You Healthy Teeth for Life.
• The 12-month membership fee is due in full upon joining.
• Membership is effective the 1st of the month of which payment is received.
• Payments are due when services are rendered.
• It is the sole responsibility of the member to maximize their benefits by arranging all the appropriate appointments within the 12- month membership period. If the appointments are not used, the member will not be entitled to a refund. All unused benefits will be forfeited if past the sign up date.
• Membership renewal fee is due the beginning of the same month each year and will be automatically renewed with a credit card on file unless specified by the member.
• The anniversary month of your membership is the month that you originally joined, regardless of when the payment is received.
• Membership fees are subject to change on anniversary date
• Must set up two cleaning appointment at the time of registration
• Our membership is NOT a dental insurance plan, and can only be used here at St. Francisville Family Dentistry
• It is nontransferable
• If you are diagnosed with Periodontal Disease, your oral health needs are more complicated, thus need more attention. You are no longer a candidate for a “Two Simple cleaning” and would require a deep cleaning. The deep cleaning (Scaling and root planning) would be covered under the 15% discount but the remainder would be paid out-of-pocket at time of service. It would be necessary to have a “periodontal maintenance” cleaning at the frequency determined by Dr. Wilson. Two periodontal maintenance cleanings can count towards your “Two Simple Cleanings”. It is likely, however, that your mouth will need additional care. Those visits will need to be paid out-of-pocket at the time of service and will be charged at a discount of 15%.
• Plan benefits do not apply to any services rendered that are covered by Workman’s compensation.
• It cannot be combined with any dental insurance.
• Fees are based on usual and customary fees at the time of service.
• Cannot be used with Care Credit.
7689 US Highway 61, 70775