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Thank you for choosing "TDA" !


 

Annual Premiums (You only pay once a Year!!)

Member (Single)

$48.00

Member & one dependent

$72.00

Member & dependents

$96.00

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WHAT ARE THE BENEFITS?

 

No Deductibles
No Claim Forms
No Annual or Lifetime Maximums
Reduced Fees
Orthodontic Coverage (Braces)
No Waiting Periods
Pre-existing Conditions Covered

After your benefits become effective, eligible members will receive oral exam, x-rays, and cleanings for a nominal fee. Additional comprehensive dental services of procedures are provided at dramatically REDUCED rates…see the schedule of services and co-payments. Members pay ONLY the amount listed for any procedure
 

LOOK AT THE SAVINGS WITH A DENTAL ECLIPSE PLAN

Dental Service

Usual Fee**

Your Plan Co-Pay

Savings in Dollars

       

Oral Exam

$41.00

$10.00

$31.00

Bitewings X-Rays

$34.00

$15.00

$19.00

Office Visit

$43.00

$ 0.00

$43.00

Fluoride (to age 14)

$21.00

$ 0.00

$21.00

Cleaning (adult)

$50.00

$25.00

$25.00

       

Total Savings (74%)

$189.00

$50

$139.00

**Usual fee is an average of dental fees throughout the state. The actual fee and savings may vary
 

HOW DO I ENROLL?

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Download the Individual or Family Enrollment Application

  

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Attach a check for the annual premium

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Mail your original completed application to our office.
Your Annual Membership Fee includes a non-refundable $10.00 enrollment and processing fee.
 

Annual Premiums (individual plan)

 

Member (single)

$48.00

Member & one dependent

$72.00

Member & dependents

$96.00

WHAT IS THE DENTAL ECLIPSE PLAN?

Total Dental Administrators, Inc. (TDA) has developed "The Dental Eclipse," a discount dental plan to give you significant savings on quality dental health care. TDA has contracted with established members of the dental profession to deliver quality dental care services in accordance with the Schedule of Covered Services & Co-payments. 

WHERE DO I RECEIVE MY DENTAL CARE?

You choose from the enclosed list of participating Dental Eclipse Plan Providers, the one most convenient for you. All covered family members must go to the same Dental Eclipse Plan Provider. The member may change facilities with a 30 day written notice and approval of the Plan. 

WHO IS ELIGIBLE?

You and your spouse are eligible, including children under age 19 or full-time students up to 26 years of age. Coverage of a child over age 19 will be continued while incapable of self-sustaining employment by reason of developmental disability or physical handicap. 

WHAT OTHER CHARGES WILL I PAY?

You will pay the member co-payments as listed on the Schedule of Covered Services. Any co-payments will be paid directly to your authorized Plan Dentist at the time of your treatment. You should discuss all future payments and costs before new appointments are made. The Dental Office staff will help you plan your dental treatment and payments. You will receive a 20% discount for all procedures not listed in the Schedule of Covered Services. Procedures performed by Endodontists, Periodontists, Pedodontists, and Oral Surgeon is provided at a 20% discount. 

IS SPECIALTY CARE COVERED?

YES, fees for Participating Plan Specialist (endodontists, periodontists, and oral surgeons) where available, will be discounted by 20%. 

WHAT IF I HAVE OTHER DENTAL COVERAGE?

Dental Eclipse is not dental insurance or a pre-paid dental plan and is not designed to coordinate with any other dental programs. If you have dental insurance or a pre-paid dental plan, all fees will be based on the usual and customary fees normally charged or the pre-paid plan's schedule of co-payments.

limitations & exclusions

 
  1. Dental care, which in the opinion of the attending dentist, is not necessary to the patient's dental health.
  2. Oral surgery requiring the setting of fractures or dislocations.
  3. Treatment for Myofunctinal therapy, except as provided herein.
  4. Dispensing of drugs and medications not normally supplies in a dental office.
  5. Treatment of malignancies, cysts, neoplasms or congenital malformations.
  6. The cost of hospital care for any dental procedures(s).
  7. Loss or theft of dentures or bridgework.
  8. Services that cannot be performed because of the general health of the Member.
  9. Services provided by a non-plan provider.
  10. Services covered by Worker's Compensation, employer liability laws, no cost services provided by any municipality, county or other governmental agency or when coverage is provided by any other group plan (insurance or prepaid).

orthodontic limitations & exclusions

 
  1. No benefits will apply for a treatment program which began before the Subscriber enrolled in the Orthodontic Plan.
  2. No benefits will apply for lost or broken appliances.
  3. No benefits will apply for lost or broken appliances.
  4. Additional fees may be charged by the dentist for:
    1. Care required in excess of 24 months from the time of banding
    2. Gross non-cooperation
    3. Accidents occurring during the period of treatment
    4. Cases involving surgical orthodontics
    5. Cases involving myofunctional therapy or T.M.J
  5. If the Subscriber relocates to an area and is unable to receive treatment from a member orthodontist, coverage under this program ceases and it becomes the obligation of the Subscriber to pay the usual and customary fee of the Orthodontist where the treatment is completed.
  6. Choice of Orthodontist, initially, after treatment begins or upon change or residence is limited to Orthodontists participating in this program or who would accept the fees
  7. If the Subscriber becomes ineligible during the course of treatment, coverage under this program ceases and it becomes the obligation of the Subscriber to pay the entire remaining balance.
 

Utah Health Phone CallPlease feel free to call us with any questions you may have. 

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