Dental Plan

ABOUT OUR IN-OFFICE DENTAL PLAN

The discounts associated with the BHF Dental Service Plan are available only through BH Franklin Dental, PLLC.

Monthly membership fees are to be paid for a minimum twelve (12) month period and are non-refundable. Unless waived by the dentist, membership will automatically renew on the anniversary date and continue thereafter until cancelled, in writing, with a minimum 30-day notice.

Qualified dependents are defined as a husband, wife, and any non-married children living in the household, as a fulltime student, under the age of 22. Any additional dependents after three (3) each will have an additional surcharge of $28 per month, per dependent.

Fees and plan discounts are subject to change without notice.

There is a $10 PPE/Sterilization fee for every member visit due a time of service.

Missed or broken appointments without 48-hour notice will be charged $75. Plan may be cancelled for three (3) missed appointments.

All member co-payments are due at time of service. Any payment returned will be charged a $25 return-fee.

Membership in the Dental Plan may be terminated for abuse, fraud or failure to pay membership fees or properly billed dental service.

The BHF Dental Service Plan is administered solely by the dental office and may be discontinued at the end of any month, with or without notice.

Dental Plan benefits are limited to $1500 per member, per anniversary year.

Dental plan benefits are not applicable until three (3) months after the initial date of acceptance except for Type I services.

Prophylaxis is limited to twice (2) every calendar year. A difficult prophylaxis (i.e. heavy smoker, neglected teeth, etc.) is subject to a $75 surcharge or type II periodontal disease treatment charges. Fluoride treatments are limited to twice (2) per calendar year, through the age of 16.

By accepting the Dental Plan, an associate will perform a comprehensive oral exam and members agree to follow prescribed maintenance program.

A denture, bridge, or other appliance installed under the Plan can be replaced only once during the period of three (3) months after the original date of installation. A denture, bridge, or other appliance can be replaced only if it is unsatisfactory and which cannot be made satisfactory by a reline or repair.

All covered replacements are subject to the co-payment percentages as listed in the Schedule of Services and the private fee schedule of BH Franklin Dental, PLLC.

There is a $200 per unit surcharge for lab work using precious metal or high noble metal.

Any dental procedure in progress or performed before or
after a member’s eligibility period is excluded.

Any dental expense incurred if the dentist is unable to perform a procedure due to the member’s general health or physical condition is excluded.

Any dental procedure not listed as a covered service, including but not limited to, anesthesia, prescription medications, trauma to the mouth, etc. is excluded.

Treatment required due to hospital and medical charges or self-inflicted wounds of any kind are excluded.

Treatment to correct congenital, developmental, or medically induced dental disorders is excluded (i.e. TMJ).

Any customized porcelain and shading, processed by an esthetic quality laboratory and technician is excluded.

Financing of copayments from an outside source through the office (i.e. Care Credit) is excluded.

Dental Plan benefits for services provided in association with benefits from another source (i.e. workman’s comp) are excluded. Coordination of BHF Dental Service Plan discounts with other dental or insurance plans is excluded

HOW IT WORKS

The BHF Private Dental Plan works similar to many dental plans on the market. You pay a monthly membership fee for benefit coverage on your dental expenses. The plan is designed to cover preventive services such as cleanings and oral exams. This provides coverage that can be budgeted at an affordable monthly expense while receiving good discounts for your higher cost dental service.

BH Franklin Dental administers the BHF Private Dental Plan and works with you, the patient, directly to make all dental service decisions. There is no need to contact a 3rd party company for information. All questions regarding plan coverage, verifying discounts, changing coverage types, or any other questions should be directed to us here at Dr. Babayev’s office.

All dental services covered by the BHF Private Dental Plan are designed to be done at the office of BH Franklin Dental. We may refer a patient to a specialist who performs other services that the patient may need, which is not covered by the Plan. The office has a full listing of recommended specialists.

Consultations 100% Coverage
Oral Exams-2per year 100% Coverage
Cleanings-2 per year 100% Coverage
X-Rays – Bitewings 100% Coverage
X-Rays – Full Mouth $80
Sealants 20% Coverage
Fillings 20% Coverage
Periodontal Service 20% Coverage
Endodontic Service 20% Coverage
Extractions-Simple 20% Coverage
Crown & Bridge Service 15% Coverage
Dentures & Partials 15% Coverage
Implant Service 15% Coverage
Orthodontic Service 15% Coverage

Teeth Whitening offered at a 15% discount.
Ask us for more information.

Ask Dr. Babayev how cosmetic
dentistry works with the Plan.

Benefits for Invisalign and Orthodontic Procedures are available.
Ask for a free consultation.

Single $ 39/month

Couple $ 74/month

Family (4) $ 124/month

Additional family member $28/month