Terms & Conditions

 

1. Not Insurance – Important Notice

This Membership Plan is not dental insurance and is not a qualified health plan under the Affordable Care Act. It is a direct payment arrangement between the patient and Family Dentistry of West Roxbury, providing savings on dental services at this office only.

2. Eligibility and Enrollment

• Memberships are available for patients not covered by a dental insurance plan.
• Plan coverage is effective immediately upon full payment and valid for 12 months from the enrollment date.
• Plans will not auto-renew without your consent. You must re-enroll annually.
• Each individual (including children) must have their own membership.

3. What’s Included

Your membership includes only the services listed under the tier you select. Services must be used during the membership year and do not roll over.

Example (Adult Plan):

• 2 routine cleanings
• 2 exams
• 1 emergency exam
• Annual check-up X-rays
• 15% discount on additional in-office dental treatments

Please refer to our brochure or website for a complete breakdown of each plan tier.

4. Exclusions & Limitations

• Cosmetic treatments (e.g., whitening, veneers)
• Orthodontics
• Services referred to specialists outside our office
• Products (e.g., toothbrushes, whitening kits)
• Lab fees or third-party charges
• Sedation dentistry
• Missed or canceled appointments

This plan is valid only for treatment rendered by Family Dentistry of West Roxbury.

5. Discount Conditions

• Offers 15–20% savings on eligible services performed in-house.
• Discounts cannot be combined with insurance, other discounts, or promotions.
• Payment is due at the time of service to receive the discount.

6. Payment & Refund Policy

• Full payment is required at enrollment via cash, credit card, or eligible HSA/FSA.
• Membership fees are non-refundable, even if services are unused.
• No refunds or prorated reimbursements will be given for early termination or relocation.

7. No-Shows and Cancellations

Missed or late-canceled appointments may result in loss of that benefit for the year. Please provide at least 24 hours’ notice for changes.

8. Termination of Plan

Family Dentistry of West Roxbury reserves the right to terminate any membership for:

• Non-payment
• Patient conduct violations
• Office policy violations

Terminated memberships will not be refunded.

9. HIPAA & Privacy

All patient information is handled in accordance with HIPAA privacy regulations and kept confidential.

10. Legal Disclaimer

This membership plan is governed by the laws of the Commonwealth of Massachusetts. By enrolling, you agree to all terms outlined above.