 Tiered Dental Services*
Provided by Patriot Health Florida, Inc.
A multi-tiered dental fee-for-service program, where you have access to dentists under THREE distinct scenarios.
Tier 1
At select participating schedule (A) Tier 1 general practitioners across the country, you will receive a no-charge exam
and x-rays in conjunction with a paid annual cleaning. Participating
providers abide by a fee schedule of fixed payments for most procedures. There are no waiting
periods or pre-existing condition limitations on this plan, and all
services including orthodontics are available immediately upon the
effective date. Fixed schedule procedure rate savings are 25% - 60% on
dental care, as compared to the American Dental Association surveys of
usual and customary fees.
Tier 2
In the event a schedule (A) Tier 1 provider is not available in a given
area, a secondary schedule participating dentist may be available at
some of the lowest rates of any national dental network.
Tier 3
In the event a Tier 1 or Tier 2 dentist is not available in your area,
please call a Customer Care Consultant for assistance in accessing a
Tier 3 provider where available.
Click here for Tier 1 & 2 Providers
Click here for Tier 3 Providers
Sample Savings at Tier 1 Participating Dentists:
(Not available in all areas)
| Common Procedures (adult) |
Your Cost |
Typical Cost** |
Your Savings |
| Oral Exam |
No Charge*** |
$81 |
$81 |
| Complete Series X-Ray Films |
No Charge*** |
$133 |
$133 |
| Filling, 1 surface permanent |
$50 |
$133 |
$83 |
| Periodontal scaling and root planing |
$101 |
$242 |
$141 |
| Root Canal therapy (anterior) |
$284 |
$694 |
$410 |
| Crown-porcelain fused to base metal |
$470 |
$922 |
$453 |
| Full Denture, upper or lower |
$507 |
$1,400 |
$893 |
| Orthodontics, children age 16 and under |
$3,338 |
$5,809 |
$2,471 |
NOTE:
Tier 1 dentists provide the greatest savings in the dental provider
network. Complete schedule can be accessed by calling 800-292-3797.
Prices on schedule are subject to change without notice. Network providers may NOT be available in certain areas.
*Patriot Health Florida, Inc. Program Features - Not available in some states.
**Source: American Dental Association, Survey Center, 2005 Survey of Dental Fees.
Contact a Customer Care Consultant for a sample fee schedule.
***In conjunction with annual check-up prophylaxis (cleaning) provided by participating
selected general practitioners of Tier 1
|
