Willamette Dental Group Office Locations & HoursWith more than 50 Locations throughout the Pacific Northwest, we likely have an office in your neighborhood.

MERIDIAN

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TWIN FALLS

AppointmentsPlease contact our Appointment Center at 1.855.4DENTAL (1-855-433-6825) for information regarding the next available appointment that meets your scheduling needs.

Appointment Center HoursMonday – Friday: 7:00 a.m. – 6:00 p.m. PTSaturday: 7:00 a.m. - 4:00 p.m. PT

Office HoursMost Willamette Dental Group offices are open Monday through Friday, 7:00 am - 6:00 p.m. and select Saturdays, for appointments.

Member Services Willamette Dental Group has a full staff of member services representatives who will answer any question that you may have about your dental plan or service.

Please reach us:Monday – Friday: 8 a.m. to 5 p.m. PTToll Free: 1.855.4DENTALE-mail: memberservices@willamettedental.com

www.WillametteDental.comVisit our website to find your nearest dental office and learn more about our providers.

Open wide to another dental option for Archdiocese of Portland in Oregon employeesWillamette Dental Group is pleased to offer you a dental plan option that will give you choice in the coverage that is best for your individual needs.

So what makes Willamette Dental Group the right choice for you and your family?We have included important information in this short flyer to let you know who we are, what we do and how we can help you and your family reach a lifetime of healthy teeth and gums.

Health is keeping it simple and family friendly.

5 Reasons Willamette Dental Group is the Plan For You & Your Family

No Annual Maximum,No DeductiblesWith no annual maximum and no deductibles, you will never exhaust your dental coverage and you don’t need to satisfy a deductible before you can receive benefits.

Predictable, Low Out-of-Pocket CostsOut-of-pocket costs for covered dental services are predictable, low copays. Combined with the low premium, you and your family won’t be surprised by any unknown costs.

Orthodontic Benefits for All AgesOrthodontics coverage is included for adults & children. With no waiting periods & a predictable, low copay, members have access to affordable orthodontic care.

Exceptional Patient SatisfactionWe are dedicated to creating the best patient experience possible. With an average score over 90% on our patient satisfaction survey, our patients tell us we are doing something right.

Proactive Dental CareThrough dentist-patient partnerships, we focus on promoting your long-term health rather than merely correcting what is bothering you today.

www.WillametteDental.comwww.fb.com/myWillametteDentalGroup

@WDGDental

Benefit Copayment

Annual Maximum No Annual Maximum

Deductible No Deductible

General & Ortho Office Visit $4 per visit (Permanent)

Diagnostic & Preventive Services

Routine & Emergency Exams Covered at 100%

X-rays Covered at 100%

Teeth Cleaning Covered at 100%

Fluoride Treatment Covered at 100%

Sealants (per tooth) Covered at 100%

Head & Neck Cancer Screening Covered at 100%

Oral Hygiene Instruction Covered at 100%

Periodontal Charting Covered at 100%

Periodontal Evaluation Covered at 100%

Restorative Dentistry & Prosthodontics

Fillings Covered at 100%

Porcelain-Metal Crowns $110

Complete Upper or Lower Denture

$110

Bridge (per tooth) $110

Endodontics & Periodontics

Root Canal Therapy $45 - $95

Osseous Surgery (per quadrant) $110

Root Planing (per quadrant) $40

Oral Surgery

Routine Extraction Covered at 100%

Surgical Extraction $70

Orthodontic Services

Pre-Orthodontic Service $150* (Permanent)

Comprehensive Orthodontia $1,700 (Permanent)

Miscellaneous

Dental Lab Fees Covered at 100%

Local Anesthesia Covered at 100%

Nitrous Oxide (per visit) $20

Specialty Office Visit $30 per visit (Permanent)

Out of Area Emergency Care is Reimbursed Up to $100 (Permanent)

Archdiocese of Portland in Oregon

Benefit Summary

*Copayment credited towards the Comprehensive Orthodontia copayment if patient accepts treatment plan.Except for copays noted above as Permanent, service copays are waived following an enrollee’s completion of three consecutive calendar years of receiving dental services while under this dental plan.

Underwritten by Willamette Dental Insurance, Inc.Please refer to your Certificate of Coverage for limitations and exclusions.Form No. 066-OR(2/16)