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MEMBERSHIP PLAN

Hickman Family Dental Membership Plan

Affordable Dental Care for Urbandale, IA

For patients in Urbandale, Clive, Waukee, Johnston, Windsor Heights, Grimes, Cumming, Norwalk, Ankeny, and the greater Des Moines area who don’t have dental insurance — or whose coverage falls short — the Hickman Family Dental Membership Plan offers a straightforward, affordable alternative. Developed by our dentists here in Urbandale, the plan gives individuals, couples, and families direct access to the preventive and restorative care they need, without the yearly caps, waiting periods, and paperwork that come with traditional insurance.

Hickman Family Dental Membership Plan

The Hickman Family Dental Membership Plan is designed to provide affordability and greater access to quality dental care.
With your comprehensive dental plan there are:
  • No Yearly Maximums
  • No Deductibles
  • No Claim Forms
  • No Waiting Periods
  • No Preauthorization Requirements
  • No Pre-Existing Conditions

Cost of Dental Plan

SINGLE

$400

(Value $600)
DUAL

$700

(Value $1,200)
FAMILY

$1,200

(Value $3,600)
The family plan includes all children (up to age 18) in the family (up to 4 children)

Coverage Table

Diagnostic & X-Rays

Comprehensive Exam (New Patient, initial visit)
100%
Periodic Exam (2 per year)
100%
Limited Oral Exam, Problem Focused (1 per year)
100%
Intraoral – Complete Series or Panorex
100%
Intraoral – Periapical, First Film
100%
Intraoral – Periapical, Each Additional Film
100%
Intraoral – Occlusal Film
100%
Bitewings (yearly, as needed)
100%

 

Preventive

Child Prophylaxis (cleaning) (2 per year)
100% (Additional Visits 15%)
Adult Prophylaxis (cleaning) (2 per year)
100% (Additional Visits 15%)
–OR–
Adult Periodontal Maintenance (2 per year)
100% (Additional Visits 15%)
Fluoride (2 per year, no age limit)
100%
Sealants
50%

All Other Procedures

Whitening
25%
Fillings
15%
Crowns
15%
Periodontics (General Denistry)
20%
Dentures and Partials
15%
Oral Surgery (limited to extractions including third molar)
15%
Root Canals
15%
Implants
15%

* This is the percent off the Current Fee Schedule.

Frequently Asked Questions

Smiling young girl in dental office, showcasing healthy teeth, promoting pediatric dental care and preventive services.

Program Exclusions and Limitations

This program is a discount plan, not a dental insurance plan.
It cannot be used:
  • In conjunction with dental insurance or another dental plan.
  • For services or injuries covered under workman’s compensation.
  • For treatment which, in the sole opinion of the treating dentist, lies outside the realm of his/her capabilities.
  • For referrals to specialists.
  • For hospitalization or hospital charges of any kind.
  • For costs of dental care which are covered under automobile, homeowners, or medical insurance.

Program Guidelines

Your plan’s effective date and record of usage will be on file at Hickman Family Dental. The cost of the Hickman Family Dental Membership Plan and the current fee schedule is subject to change.

The cost of the plan is NON-REFUNDABLE. No refunds will be issued if the patient elects not to utilize. Patients portion of bill is due on day of service. We gladly accept personal checks, most credit cards and debit cards, and cash.

Ready to Enroll in the Membership Plan?

Ready to enroll? Our front desk team can walk you through the Single, Dual, and Family plan options and get you set up in just a few minutes — no waiting period, so you can start using your benefits right away. Call us at (515) 276-4981 or stop by our Urbandale office at 7117 Hickman Road, and we’ll help you choose the plan that fits your family’s needs.

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