Wellness Plan Membership

*Exclusions: Cosmetic cases, Invisalign, and Dental Implants

* Lab fee(s) Not included

**Some limitations apply

Annual Fee

• Adults – $600
• Children (Under 18) – $475
• Couples – $1,100

 CSD Wellness Program Guidelines

You will not receive a membership card- your plan’s effective date, credit card or bank information will be on file with our financial coordinator and will be effective for 12 months, beginning on the date of purchase.

Renewal will be automatic unless notified 30 days prior to the end of the fiscal year. Benefit coverage is subject to revision annually

NON-REFUNDABLE-No refunds or premiums will be issued at any time if participant decides not to utilize dental plan

All payments are due AT TIME OF SERVICE to receive the discount. All services received that are not paid for at the time of service will be billed at the usual, higher fee. If you choose to extend your payment for treatment by paying through CareCredit, the restorative treatment discount is reduced to 10% due to merchant fees. This offer cannot be combined with any other offers. Plan fees are valid only when paid at time of enrollment.

Appointments must be confirmed, a failed appointment will be considered as your benefits used. As such there are no refunds on deposits made to pre-appoint. Plan does not cover lab fees. Plan does not cover cosmetic Cases.

CSD Wellness Program Exclusions and Limitations:

This program is a savings plan, not a dental insurance plan.

It cannot be used:

• In conjunction with another dental plan
• For services for injuries covered under workman’s compensation
• For treatment which, in the sole opinion of the treating dentist or doctor, lies outside the realm of their capability
• Does not apply when patient is referred to a specialists
• For hospitalization or hospital charges of any kind
• For cost of dental care which are covered under automobile medical claims

This plan is only honored at the office of Dr. Peter M. Tomaselli. This dental Wellness plan is not an insurance plan and cannot be used at any other dental office.