Our Smile Club discount plan is designed for your whole family to provide quality dental care, at discounted rates, for those who do not have insurance. The plan is based on an automatic renewal membership. When signing up for this plan, your credit card number is kept in your file at our office, so that we can alert you to any fee increases, one month in advance of your renewal date. Membership cards are not required as we provide all plan monitoring from our office for your privacy and convenience.
*This is a discount plan and is only honored at Leesburg Dental.
Club Discounts on Treatment
Our Smile Club discount plan is designed for your whole family to provide quality dental care, at discounted rates, for those who do not have insurance.
This plan is based on an automatic renewal membership. When signing up for this plan, your credit card number is kept in your file at our office, s taht we can altert you to any fee inscrease, one m onth in advance of your renewal date.
Membership Cards are not required as we provide all plan monitoring from our office for your privacy and convenience.
|Family (4) **||$899|
* Dual plan is for Parent/Child or Husband/Wife only.
** The Family Plan includes two adults two children provided they are under the age of 18. The anual fee for each additional child will be $150.
|Diagnostic & X-Rays|
|Comprehensive Exam (new patient, initial visit)||100%|
|Periodic Exam (2x per year)||100%|
|Limited Oral Exam (problem focused)(1 per year)||100%|
|Intraoral-Complete Series or Pano (1 every 5 years)||100%|
|Intraoral-Periapical, each additional film||100%|
|Bitewing X-Rays (1 per year)||100%|
|Child Prophylaxis (cleaning)(2 per year)||100%|
|Adult Prophylaxis (cleaning)(2 per year)||100%|
|Additional Cleanings per year||20%|
|Fluoride (2 per year, until age 21)||100%|
|Sealants (until age 21)||20%|
|All Other Procedures|
|Filllings & Core Build Ups||20%|
|Periodontics (Deep Cleaning)||20%|
|Dentures & Partials||20%|
|Orthodontics (Insisalign)*||$500 Off|
*For orthodontics: Member must remain a plan member for the duration of treatment to retain discount plan benefits.
Membership Guidelines and Limitations
- Membership enrollment fees must be PAID prior to any dental care procedures.
- If the participant does not utiize their savings club benefits, the plan is NON-REFUNDABLE and offers no additional discounts.
- Club memberrs portion of the billing for services is due on the day of service.
- Membershipi discounts do not apply to dental products.
- A reinstatement fee of $50 is due if your membership lapses.
- Additional discounts DO NOT apply.
- CareCredit is not allowed as payment toward premium or services.
This program is a discount plan, not a dental insurance plan. This program is honored only at Leesburg Dental.
This plan cannot be used for:
- Services in conjunction with any other dental plan.
- Injuries covered under the accident policy (school or home).
- Any treatment which lies outside the expertise of Dr. Loza.
- Specialist referrals.
- Hospital charges or hospitalizations of any kind.
- Dental care costs covered undder the automobile medical policy.