INTEGRATED HEALTH CHOICES VISION PLAN
PROVIDER:
VISION WITHOUT LIMITS OF CANTON
This plan entitles members to the following Vision services Savings
| Service |
Our Fee |
|
Discounted Fee |
| |
|
|
|
|
Well Eye Exam
Contact Lens Evaluation
Contact Lenses
Frames
Single Vision Lenses
Bifocal/Trifocal Lenses
Progressive Lenses
HD Digital SV Lenses
HD Digital Progressive
|
75.00
60.00
49.00
45.00
95.00
130.00
219.00
299.00
499.00
|
|
56.00
45.00
39.00
33.00
69.00
95.00
159.00
218.00
364.00
|
| |
|
|
|
Promotion:
30% off prescription sunglasses with the purchase of glsses (frame and lenses) or contact lenses
|
|
INTEGRATED HEALTH CHOICES DENTAL PLAN
NEW PATIENT BENEFIT OPTIONS
With your first new patient comprehensive appointment, you will be entitled to one of the following options below. This is included in your benefit program
Sonicare Power Toothbrush
Value - $ 80
Zoom Bleaching - 2 hour in office procedure to lighten teeth color
Value - $ 400
$ 200 voucher - Apply toward any of the following dental procedures:
Crowns/Bridges
Root
Canals
Dentures
Extractions
$ 500 voucher - Apply toward any major dental work over $2.500, such as:
Cosmetic makeover (4 or more teeth required)
Implant placement and crown restoration
Invisalign (clear teeth aligners)
INTEGRATED HEALTH CHOICES DENTAL PLAN
Provider:
ALL ABOUT SMILES OF CANTON
This plan entitles members to 30% off all dental services Sample Plan Savings
| |
Our Fee |
Plan Fee |
*Initial Oral Exam: Includes basic prophy/cleaning if required,
full mouth radiographs, cancer exam, oral exam and treatment plan. |
$ 285.00 |
$ 199.00 |
Routine 6 month exam
Four Bitewing X-Rays
1 Periapical X-Ray
Adult Teeth Cleaning
Child Teeth Cleaning
1 Surface white filling
2 Surface white filling
Single Crown All Porcelain
Core Build Up
Post and Core Build up
Root Canal - Molar
Root Canal - Anterior Tooth
Root Canal - Bicuspid Tooth
Full Upper Denture
Full Lower Denture
Simple Extraction + x-ray
Surgical Extraction + x-ray
Perio Scaling and Root Planning
(per quadrant)
Perio Maintenance every 4 months
Perio Scaling and Root Planning
(1-3 teeth)
Implant Placement and Crown
Bone Graft |
$ 50.00
$ 60.00
$ 24.00
$ 90.00
$ 60.00
$ 135.00
$ 175.00
$ 925.00
$ 220.00
$ 325.00
$ 910.00
$ 765.00
$ 865.00
$ 1500.00
$ 1500.00
$ 165.00
$ 275.00
$ 230.00
$ 160.00
$ 160.00
$ 3,310.00
$ 210.00
|
$ 35.00
$ 42.00
$ 16.00
$ 63.00
$ 40.00
$ 94.00
$ 122.00
$ 647.00
$ 154.00
$ 227.00
$ 637.00
$ 535.00
$ 605.00
$ 950.00
$ 950.00
$ 124.00
$ 192.00
$ 161.00
$ 112.00
$ 112.00
$ 2317.00
$ 150
|
| |
|
|
The IHC Dental Plan offers savings on over 170 common dental procedures. Members receive a discount on the fees normally charged by the provider.
The sample table above is a small selection of common procedures discounted by the IHC Dental Plan. Once you're a member, you will be provided with a complete schedule of benefits with discounted fees for many common dental procedures. Other procedures discounted under the IHC Dental Plan offer savings similar to the sample above. If you are looking for a specific dental procedure that is not in this sample, please contact us with the ADA Code of the procedure and we can provide the discounted fee.
|
|
|
|
|
|
|
