Ophthalmology Exams
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AmeriPlan® Corporation 5700 Democracy Drive Plano, TX 75024 A Discount Medical Plan Organization AmeriPlan Health® is NOT insurance.
First Name Member Information
These discount medical plans are NOT health insurance or a MediCare Prescription Drug Plan. Membership in these programs entitles you to discounts for certain medical services and prescription drugs by providers who have agreed to participate in these discount programs. These programs do NOT make payments directly to the providers of medical services and prescription drugs. The programs’ members are obligated to pay for all healthcare services, but will receive a discount from those healthcare providers who have contracted with these discount programs. The name, address and specialty of the discount medical and prescription drug program providers in your service area are available before purchase and upon request by logging on to www.ameriplanusaprovidersearch.com or call the AmeriPlan® Consumer Information Center at 1-800-647-8421.
AmeriPlan ® Discount Medical Plan Membership Application
Date of Birth of Applicant
Residence or Work Telephone
Alternate Telephone Apt.# State
First Name
Last Name
Zip
LIST ADDITIONAL HOUSEHOLD MEMBERS ON A SEPARATE SHEET OF PAPER.
Date of Birth
E-MAIL ADDRESS
Total Health Plus Dental, Vision, Prescription, Chiropractic, Physician, Ancillary, Hospital Advocacy, NurseLine, and Podiatry Plus Non-Medical Discount Programs Auto Club, Identity Theft Assistance, Legal
5700 Democracy Drive Plano, Texas 75024 A Discount Medical Plan Organization
Monthly Health Fee - $39.95
Quarterly Health Fee - $119.85
Annual Health Fee - $479.40
Non-Medical Fee -
$20.00
Non-Medical Fee -
Non-Medical Fee -
TOTAL AMOUNT-
$59.95
TOTAL AMOUNT-
$60.00 $179.85
$240.00
TOTAL AMOUNT- $719.40
By submitting your enclosed check, you are authorizing the ongoing draft until AmeriPlan® is notified of cancellation in writing. ® First Month Membership Fee
I WANT TO PAY MY MONTHLY OR QUARTERLY MEMBERSHIP FEE BY: BANK DRAFT: Please Draft on the
3rd or
CREDIT CARD:
Discover
Card #
For more information, contact AmeriPlan® IBO:
Male/Female
Last Name
Mailing Address
AmeriPlan® Corporation The average savings on the most utilized provider procedures stated in this brochure are only a sample from the discount fee schedule that each AmeriPlan® provider has agreed to honor for members. The discounts represent a reduction on a treatment or percentage basis of the usual and customary fees charged by the providers for a specific treatment. AmeriPlan® confirms that its medical, dental, vision, chiropractic and pharmacy providers are professionally licensed in your state, but does not guarantee the quality of the services or products. Quality of care complaints should be addressed to the appropriate licensing agency in your state. If you are not sure whom to call regarding quality of care complaints, contact the Consumer Information Center at 1-800-647-8421. If you have health insurance, this discount medical plan may be duplicative of your health insurance.
MI
IBO #
City Household Members
DISCLOSURES TO CONSUMERS:
Visa
MasterCard
18th of the month. American Express Expiration Date
$
Total Monthly Fee -$59.95
First Quarter Membership Fee
$
Total Quarterly Fee -$179.85
Annual Membership Fee
$
Total Annual Fee -$719.40
One-time Registration Fee
$
Total Health Plus Registration Fee $30.00re NON REFUNDABLE
X
TOTAL AMOUNT DUE SIGNATURE FOR CREDIT CARD OR BANK DRAFT
AMP017T (06/08)
MONTHLY OR QUARTERLY PAYMENTS MUST BE MADE BY ELECTRONIC BANK DRAFT OR BY CREDIT CARD. INVOICING IS AVAILABLE FOR ANNUAL MEMBERSHIPS ONLY WITH FIRST YEAR PAID IN ADVANCE.
Enclose your check for payment and a voided check if paying monthly or quarterly by bank draft.
DISCOUNTS ARE NOT INSURANCE
Page 1
© 2008 AmeriPlan® Corporation. All rights reserved.
DPR.06.08
$
Example of savings on the most utilized dental procedures: Sample General Dentist Procedures*
Dental Office Fees** up to
D0150 - Initial Oral Exam D0120 - Periodic Oral Exam
AmeriPlan® Fees Up To
AmeriPlan® Discount Programs are
AmeriPlan® Savings
NOT INSURANCE!
$118
$37
70
14
69% 80%
D0210 - Intraoral Complete Series 162
65
60%
117
47
60%
174
70
60%
201
95
53%
X-Rays
What makes AmeriPlan Dental Plus™
D1110 - Regular Teeth Cleaning (Light Scaling & Polishing)
Amalgam Fillings (Silver Colored) D2140 - 1 Surface Primary or Permanent
Composite Filling
(Tooth Colored)
D2330 - 1 Surface (Anterior) D3310 - Anterior
D2750 - Porcelain Crown
902
375
58%
1,365
550
60%
5,000 5,500
2,100 2,250
58% 59%
(w/High Noble Metal)
Orthodontic Treatment (Braces) (Invisalign Braces may not be included.) by General Dentist D8080 - Child (under age 19) D8090 - Adult (age 19 and over)
* Current Dental Terminology © 2008 American Dental Association, All Rights Reserved. **National Dental Advisory Service 2008. Different fees may apply in different areas of your state. For the appropriate fees for your area, go to
www.ameriplanusaprovidersearch.com or call 1-800-647-8421.
Example of savings on medical procedures in a general physician’s* office (family physician) and laboratory fees:
~ MORE THAN 30,000 DENTAL PROVIDERS NATIONWIDE. ~ NO LIMIT ON VISITS OR SERVICES. ~ ONGOING DENTAL PROBLEMS ARE ACCEPTED, (Except Dental and Orthodontic ~ ~ ~ ~ ~ ~ ~
INSTANT SAVINGS. NO AGE LIMIT. NO PAPERWORK. NO WAITING PERIOD. ORTHODONTICS (braces) AND COSMETIC DENTISTRY INCLUDED. SPECIALISTS INCLUDED, (where available.) YOU CAN CHANGE DENTISTS.
Vision: ~ MORE THAN 12,000 OPTICAL PROVIDERS NATIONWIDE. ~ SAVE FROM 20% TO 60% on all frames, lenses, tints, scratch-resistant coatings and ultra-violet protection. ~ SAVE FROM 10% TO 50% on ophthalmology eye exams, and LASIK surgery with certain providers in selected markets. ~ SAVE FROM 10% TO 20% ON CONTACT LENSES (excluding disposables) at participating retail locations. ~ SPECIAL SAVINGS FROM 10% TO 40% ON REPLACEMENT CONTACT LENSES. Including daily wear, extended wear, disposable, tinted, bifocals and gas permeable.* ~ ADDITIONAL DISCOUNTS on designer non-prescription sunglasses with the world’s largest online optical store.** ~ 30-DAY UNCONDITIONAL money-back guarantee on all merchandise. ~ TOLL-FREE NUMBER to locate independent and participating chain network providers. * Available through mail order program only. ** Available through Internet program only.
Sample General Physician Procedures* and Lab Sevices
Physician*/Lab AmeriPlan® Fees up to** Fees
New Patient Intermediate Visit Extended Visit Established Patient Limited Visit Intermediate Visit Laboratory Fees Lipid Panel
$187 289
125 189
88
AmeriPlan® Savings
$112 173
75 114
11
40% 40%
Includes ALL of our Health and Dental Programs …
Dental, Vision, Prescription, Chiropractic, Physician, Ancillary Services, Hospital Advocacy, NurseLine, and Podiatry… and More:
87%
37
14
* Specialists’ fees will be slightly higher. ** Physicians fee reference 2008. Different fees may apply in different areas of your state.
62%
Physician: ~ ~ ~ ~ ~ ~ ~ ~ ~
NO WAITING PERIOD. NO PRE-AUTHORIZATION FOR TREATMENT REQUIRED. NO PAPERWORK. INSTANT SAVINGS. SPECIALISTS INCLUDED, WHERE AVAILABLE. MOST ONGOING MEDICAL PROBLEMS ARE INCLUDED. COSMETIC SURGERY INCLUDED, WHERE AVAILABLE. NO AGE LIMIT. YOU CAN CHANGE PHYSICIANS.
Ancillary Services: Includes services such as physical therapy, laboratory procedures, imaging centers, hearing services, mental health services, and diabetic supplies.
Prescription: ~ OVER 56,000 PARTICIPATING RETAIL AND INDEPENDENT PHARMACY LOCATIONS NATIONWIDE* ~ Save 10% - 85% on most brand name and generic prescription drugs** ~ Save on over the counter medications, smoking cessation aids and diabetes supplies ~ Mail order pharmacy option available ~ No cost prescriptions - You may qualify for AmeriPlan's Prescription Advocacy Program. Pharmacy discounts are NOT insurance services or a MediCare Precription Drug Plan and are NOT intended as a substitue for insurance.
40% 40%
(Cholesterol, HDL, LDL, Triglycerides)
CBC (Complete Blood Count)
The COMPLETE package !
Dental:
treatments in progress.)
Root Canal (Excluding Final Restoration)
* Discounts are available only at participating pharmacies. ** You may not receive a savings on some high-volume or maintenance type drug since these medications may have already been reduced at the pharmacy level.
Chiropractic: ~ ~ ~ ~ ~ ~
MORE THAN 7,500 PARTICIPATING DOCTORS. FREE INITIAL CONSULTATION. 50% SAVINGS on all diagnostic services & required x-rays. 30% SAVINGS on treatment and most other services. NO LIMIT on number of visits. TOLL-FREE NUMBER to locate participating network chiropractors.
Different ... and Better?
Hospital Advocacy: Should you need to be hospitalized, and the anticipated charges will exceed $2,500.00, an advocate will be assigned to negotiate the best possible fees for the hospital services. There is a three-day waiting period from the active date of your membership to utilize this program.
AmeriPlan® Auto Club Administered by United States Auto Club-Motoring Divison
Auto Club - There is nothing more frustrating than having trouble with your car while on the road. And if the trouble with the car isn’t enough, you sure don’t want trouble getting immediate assistance. Membership in the AmeriPlan® Auto Club program will give you the service, comfort and savings to lessen your bad experience. Reliable, qualified service providers are available 24/7. The first $50.00 of emergency roadside or towing services will cost you nothing, just sign your name and drive away. Additional charges are discounted by at least 25% off of the retail price. While breakdowns are never fun, this program lessens the pain.
AmeriPlan® Identity Theft Assistance Administered by CLC
Identity Theft - Today, Identity Theft has become a $50 billion problem in the United States. More and more people at all levels of society are becoming victims. What once was a problem for the wealthy has become a problem for all of us. There are two important elements of the identity theft issue that applies to everyone. First is the matter of prevention and second is the matter of resolution after the fact. This CLC Identity Theft Program addresses both of these issues.
AmeriPlan® Legal
CONSUMER HEALTH ALLIANCE
Administered by CLC
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Legal and Financial - Should you have the need to consult an attorney, this program will give you a FREE one hour initial consultation for each occurrence and a 25% discount on any ongoing legal fees. You will also have access to over 4,500 online legal documents, along with a complete legal reference resource.
NurseLine At no cost you can address immediate health matters or get your health questions answered by a licensed registered nurse 24/7. You may save hours lost while waiting in a doctor’s office, missed time from work and even the high cost of office visits.
Podiatry Services: Foot and ankle specialists provide comprehensive management, through medical or surgical methods, of a wide variety of problems that affect foot and ankle function.
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
C H Not Available in South Carolina ONSUMER
EALTH ALLIANCE
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Member in Good Standing
U.S. Chamber of Commerce
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Example of savings on the most utilized dental procedures: Sample General Dentist Procedures*
Dental Office Fees** up to
D0150 - Initial Oral Exam D0120 - Periodic Oral Exam
AmeriPlan® Fees Up To
AmeriPlan® Discount Programs are
AmeriPlan® Savings
NOT INSURANCE!
$118
$37
70
14
69% 80%
D0210 - Intraoral Complete Series 162
65
60%
117
47
60%
174
70
60%
201
95
53%
X-Rays
What makes AmeriPlan Dental Plus™
D1110 - Regular Teeth Cleaning (Light Scaling & Polishing)
Amalgam Fillings (Silver Colored) D2140 - 1 Surface Primary or Permanent
Composite Filling
(Tooth Colored)
D2330 - 1 Surface (Anterior) D3310 - Anterior
D2750 - Porcelain Crown
902
375
58%
1,365
550
60%
5,000 5,500
2,100 2,250
58% 59%
(w/High Noble Metal)
Orthodontic Treatment (Braces) (Invisalign Braces may not be included.) by General Dentist D8080 - Child (under age 19) D8090 - Adult (age 19 and over)
* Current Dental Terminology © 2008 American Dental Association, All Rights Reserved. **National Dental Advisory Service 2008. Different fees may apply in different areas of your state. For the appropriate fees for your area, go to
www.ameriplanusaprovidersearch.com or call 1-800-647-8421.
Example of savings on medical procedures in a general physician’s* office (family physician) and laboratory fees:
~ MORE THAN 30,000 DENTAL PROVIDERS NATIONWIDE. ~ NO LIMIT ON VISITS OR SERVICES. ~ ONGOING DENTAL PROBLEMS ARE ACCEPTED, (Except Dental and Orthodontic ~ ~ ~ ~ ~ ~ ~
INSTANT SAVINGS. NO AGE LIMIT. NO PAPERWORK. NO WAITING PERIOD. ORTHODONTICS (braces) AND COSMETIC DENTISTRY INCLUDED. SPECIALISTS INCLUDED, (where available.) YOU CAN CHANGE DENTISTS.
Vision: ~ MORE THAN 12,000 OPTICAL PROVIDERS NATIONWIDE. ~ SAVE FROM 20% TO 60% on all frames, lenses, tints, scratch-resistant coatings and ultra-violet protection. ~ SAVE FROM 10% TO 50% on ophthalmology eye exams, and LASIK surgery with certain providers in selected markets. ~ SAVE FROM 10% TO 20% ON CONTACT LENSES (excluding disposables) at participating retail locations. ~ SPECIAL SAVINGS FROM 10% TO 40% ON REPLACEMENT CONTACT LENSES. Including daily wear, extended wear, disposable, tinted, bifocals and gas permeable.* ~ ADDITIONAL DISCOUNTS on designer non-prescription sunglasses with the world’s largest online optical store.** ~ 30-DAY UNCONDITIONAL money-back guarantee on all merchandise. ~ TOLL-FREE NUMBER to locate independent and participating chain network providers. * Available through mail order program only. ** Available through Internet program only.
Sample General Physician Procedures* and Lab Sevices
Physician*/Lab AmeriPlan® Fees up to** Fees
New Patient Intermediate Visit Extended Visit Established Patient Limited Visit Intermediate Visit Laboratory Fees Lipid Panel
$187 289
125 189
88
AmeriPlan® Savings
$112 173
75 114
11
40% 40%
Includes ALL of our Health and Dental Programs …
Dental, Vision, Prescription, Chiropractic, Physician, Ancillary Services, Hospital Advocacy, NurseLine, and Podiatry… and More:
87%
37
14
* Specialists’ fees will be slightly higher. ** Physicians fee reference 2008. Different fees may apply in different areas of your state.
62%
Physician: ~ ~ ~ ~ ~ ~ ~ ~ ~
NO WAITING PERIOD. NO PRE-AUTHORIZATION FOR TREATMENT REQUIRED. NO PAPERWORK. INSTANT SAVINGS. SPECIALISTS INCLUDED, WHERE AVAILABLE. MOST ONGOING MEDICAL PROBLEMS ARE INCLUDED. COSMETIC SURGERY INCLUDED, WHERE AVAILABLE. NO AGE LIMIT. YOU CAN CHANGE PHYSICIANS.
Ancillary Services: Includes services such as physical therapy, laboratory procedures, imaging centers, hearing services, mental health services, and diabetic supplies.
Prescription: ~ OVER 56,000 PARTICIPATING RETAIL AND INDEPENDENT PHARMACY LOCATIONS NATIONWIDE* ~ Save 10% - 85% on most brand name and generic prescription drugs** ~ Save on over the counter medications, smoking cessation aids and diabetes supplies ~ Mail order pharmacy option available ~ No cost prescriptions - You may qualify for AmeriPlan's Prescription Advocacy Program. Pharmacy discounts are NOT insurance services or a MediCare Precription Drug Plan and are NOT intended as a substitue for insurance.
40% 40%
(Cholesterol, HDL, LDL, Triglycerides)
CBC (Complete Blood Count)
The COMPLETE package !
Dental:
treatments in progress.)
Root Canal (Excluding Final Restoration)
* Discounts are available only at participating pharmacies. ** You may not receive a savings on some high-volume or maintenance type drug since these medications may have already been reduced at the pharmacy level.
Chiropractic: ~ ~ ~ ~ ~ ~
MORE THAN 7,500 PARTICIPATING DOCTORS. FREE INITIAL CONSULTATION. 50% SAVINGS on all diagnostic services & required x-rays. 30% SAVINGS on treatment and most other services. NO LIMIT on number of visits. TOLL-FREE NUMBER to locate participating network chiropractors.
Different ... and Better?
Hospital Advocacy: Should you need to be hospitalized, and the anticipated charges will exceed $2,500.00, an advocate will be assigned to negotiate the best possible fees for the hospital services. There is a three-day waiting period from the active date of your membership to utilize this program.
AmeriPlan® Auto Club Administered by United States Auto Club-Motoring Divison
Auto Club - There is nothing more frustrating than having trouble with your car while on the road. And if the trouble with the car isn’t enough, you sure don’t want trouble getting immediate assistance. Membership in the AmeriPlan® Auto Club program will give you the service, comfort and savings to lessen your bad experience. Reliable, qualified service providers are available 24/7. The first $50.00 of emergency roadside or towing services will cost you nothing, just sign your name and drive away. Additional charges are discounted by at least 25% off of the retail price. While breakdowns are never fun, this program lessens the pain.
AmeriPlan® Identity Theft Assistance Administered by CLC
Identity Theft - Today, Identity Theft has become a $50 billion problem in the United States. More and more people at all levels of society are becoming victims. What once was a problem for the wealthy has become a problem for all of us. There are two important elements of the identity theft issue that applies to everyone. First is the matter of prevention and second is the matter of resolution after the fact. This CLC Identity Theft Program addresses both of these issues.
AmeriPlan® Legal
CONSUMER HEALTH ALLIANCE
Administered by CLC
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Legal and Financial - Should you have the need to consult an attorney, this program will give you a FREE one hour initial consultation for each occurrence and a 25% discount on any ongoing legal fees. You will also have access to over 4,500 online legal documents, along with a complete legal reference resource.
NurseLine At no cost you can address immediate health matters or get your health questions answered by a licensed registered nurse 24/7. You may save hours lost while waiting in a doctor’s office, missed time from work and even the high cost of office visits.
Podiatry Services: Foot and ankle specialists provide comprehensive management, through medical or surgical methods, of a wide variety of problems that affect foot and ankle function.
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
C H Not Available in South Carolina ONSUMER
EALTH ALLIANCE
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Member in Good Standing
U.S. Chamber of Commerce
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
First Name Member Information
These discount medical plans are NOT health insurance or a MediCare Prescription Drug Plan. Membership in these programs entitles you to discounts for certain medical services and prescription drugs by providers who have agreed to participate in these discount programs. These programs do NOT make payments directly to the providers of medical services and prescription drugs. The programs’ members are obligated to pay for all healthcare services, but will receive a discount from those healthcare providers who have contracted with these discount programs. The name, address and specialty of the discount medical and prescription drug program providers in your service area are available before purchase and upon request by logging on to www.ameriplanusaprovidersearch.com or call the AmeriPlan® Consumer Information Center at 1-800-647-8421.
AmeriPlan ® Discount Medical Plan Membership Application
Date of Birth of Applicant
Residence or Work Telephone
Alternate Telephone Apt.# State
First Name
Last Name
Zip
LIST ADDITIONAL HOUSEHOLD MEMBERS ON A SEPARATE SHEET OF PAPER.
Date of Birth
E-MAIL ADDRESS
Total Health Plus Dental, Vision, Prescription, Chiropractic, Physician, Ancillary, Hospital Advocacy, NurseLine, and Podiatry Plus Non-Medical Discount Programs Auto Club, Identity Theft Assistance, Legal
5700 Democracy Drive Plano, Texas 75024 A Discount Medical Plan Organization
Monthly Health Fee - $39.95
Quarterly Health Fee - $119.85
Annual Health Fee - $479.40
Non-Medical Fee -
$20.00
Non-Medical Fee -
Non-Medical Fee -
TOTAL AMOUNT-
$59.95
TOTAL AMOUNT-
$60.00 $179.85
$240.00
TOTAL AMOUNT- $719.40
By submitting your enclosed check, you are authorizing the ongoing draft until AmeriPlan® is notified of cancellation in writing. ® First Month Membership Fee
I WANT TO PAY MY MONTHLY OR QUARTERLY MEMBERSHIP FEE BY: BANK DRAFT: Please Draft on the
3rd or
CREDIT CARD:
Discover
Card #
For more information, contact AmeriPlan® IBO:
Male/Female
Last Name
Mailing Address
AmeriPlan® Corporation The average savings on the most utilized provider procedures stated in this brochure are only a sample from the discount fee schedule that each AmeriPlan® provider has agreed to honor for members. The discounts represent a reduction on a treatment or percentage basis of the usual and customary fees charged by the providers for a specific treatment. AmeriPlan® confirms that its medical, dental, vision, chiropractic and pharmacy providers are professionally licensed in your state, but does not guarantee the quality of the services or products. Quality of care complaints should be addressed to the appropriate licensing agency in your state. If you are not sure whom to call regarding quality of care complaints, contact the Consumer Information Center at 1-800-647-8421. If you have health insurance, this discount medical plan may be duplicative of your health insurance.
MI
IBO #
City Household Members
DISCLOSURES TO CONSUMERS:
Visa
MasterCard
18th of the month. American Express Expiration Date
$
Total Monthly Fee -$59.95
First Quarter Membership Fee
$
Total Quarterly Fee -$179.85
Annual Membership Fee
$
Total Annual Fee -$719.40
One-time Registration Fee
$
Total Health Plus Registration Fee $30.00re NON REFUNDABLE
X
TOTAL AMOUNT DUE SIGNATURE FOR CREDIT CARD OR BANK DRAFT
AMP017T (06/08)
MONTHLY OR QUARTERLY PAYMENTS MUST BE MADE BY ELECTRONIC BANK DRAFT OR BY CREDIT CARD. INVOICING IS AVAILABLE FOR ANNUAL MEMBERSHIPS ONLY WITH FIRST YEAR PAID IN ADVANCE.
Enclose your check for payment and a voided check if paying monthly or quarterly by bank draft.
DISCOUNTS ARE NOT INSURANCE
Page 1
© 2008 AmeriPlan® Corporation. All rights reserved.
DPR.06.08
$
Example of savings on the most utilized dental procedures: Sample General Dentist Procedures*
Dental Office Fees** up to
D0150 - Initial Oral Exam D0120 - Periodic Oral Exam
AmeriPlan® Fees Up To
AmeriPlan® Discount Programs are
AmeriPlan® Savings
NOT INSURANCE!
$118
$37
70
14
69% 80%
D0210 - Intraoral Complete Series 162
65
60%
117
47
60%
174
70
60%
201
95
53%
X-Rays
What makes AmeriPlan Dental Plus™
D1110 - Regular Teeth Cleaning (Light Scaling & Polishing)
Amalgam Fillings (Silver Colored) D2140 - 1 Surface Primary or Permanent
Composite Filling
(Tooth Colored)
D2330 - 1 Surface (Anterior) D3310 - Anterior
D2750 - Porcelain Crown
902
375
58%
1,365
550
60%
5,000 5,500
2,100 2,250
58% 59%
(w/High Noble Metal)
Orthodontic Treatment (Braces) (Invisalign Braces may not be included.) by General Dentist D8080 - Child (under age 19) D8090 - Adult (age 19 and over)
* Current Dental Terminology © 2008 American Dental Association, All Rights Reserved. **National Dental Advisory Service 2008. Different fees may apply in different areas of your state. For the appropriate fees for your area, go to
www.ameriplanusaprovidersearch.com or call 1-800-647-8421.
Example of savings on medical procedures in a general physician’s* office (family physician) and laboratory fees:
~ MORE THAN 30,000 DENTAL PROVIDERS NATIONWIDE. ~ NO LIMIT ON VISITS OR SERVICES. ~ ONGOING DENTAL PROBLEMS ARE ACCEPTED, (Except Dental and Orthodontic ~ ~ ~ ~ ~ ~ ~
INSTANT SAVINGS. NO AGE LIMIT. NO PAPERWORK. NO WAITING PERIOD. ORTHODONTICS (braces) AND COSMETIC DENTISTRY INCLUDED. SPECIALISTS INCLUDED, (where available.) YOU CAN CHANGE DENTISTS.
Vision: ~ MORE THAN 12,000 OPTICAL PROVIDERS NATIONWIDE. ~ SAVE FROM 20% TO 60% on all frames, lenses, tints, scratch-resistant coatings and ultra-violet protection. ~ SAVE FROM 10% TO 50% on ophthalmology eye exams, and LASIK surgery with certain providers in selected markets. ~ SAVE FROM 10% TO 20% ON CONTACT LENSES (excluding disposables) at participating retail locations. ~ SPECIAL SAVINGS FROM 10% TO 40% ON REPLACEMENT CONTACT LENSES. Including daily wear, extended wear, disposable, tinted, bifocals and gas permeable.* ~ ADDITIONAL DISCOUNTS on designer non-prescription sunglasses with the world’s largest online optical store.** ~ 30-DAY UNCONDITIONAL money-back guarantee on all merchandise. ~ TOLL-FREE NUMBER to locate independent and participating chain network providers. * Available through mail order program only. ** Available through Internet program only.
Sample General Physician Procedures* and Lab Sevices
Physician*/Lab AmeriPlan® Fees up to** Fees
New Patient Intermediate Visit Extended Visit Established Patient Limited Visit Intermediate Visit Laboratory Fees Lipid Panel
$187 289
125 189
88
AmeriPlan® Savings
$112 173
75 114
11
40% 40%
Includes ALL of our Health and Dental Programs …
Dental, Vision, Prescription, Chiropractic, Physician, Ancillary Services, Hospital Advocacy, NurseLine, and Podiatry… and More:
87%
37
14
* Specialists’ fees will be slightly higher. ** Physicians fee reference 2008. Different fees may apply in different areas of your state.
62%
Physician: ~ ~ ~ ~ ~ ~ ~ ~ ~
NO WAITING PERIOD. NO PRE-AUTHORIZATION FOR TREATMENT REQUIRED. NO PAPERWORK. INSTANT SAVINGS. SPECIALISTS INCLUDED, WHERE AVAILABLE. MOST ONGOING MEDICAL PROBLEMS ARE INCLUDED. COSMETIC SURGERY INCLUDED, WHERE AVAILABLE. NO AGE LIMIT. YOU CAN CHANGE PHYSICIANS.
Ancillary Services: Includes services such as physical therapy, laboratory procedures, imaging centers, hearing services, mental health services, and diabetic supplies.
Prescription: ~ OVER 56,000 PARTICIPATING RETAIL AND INDEPENDENT PHARMACY LOCATIONS NATIONWIDE* ~ Save 10% - 85% on most brand name and generic prescription drugs** ~ Save on over the counter medications, smoking cessation aids and diabetes supplies ~ Mail order pharmacy option available ~ No cost prescriptions - You may qualify for AmeriPlan's Prescription Advocacy Program. Pharmacy discounts are NOT insurance services or a MediCare Precription Drug Plan and are NOT intended as a substitue for insurance.
40% 40%
(Cholesterol, HDL, LDL, Triglycerides)
CBC (Complete Blood Count)
The COMPLETE package !
Dental:
treatments in progress.)
Root Canal (Excluding Final Restoration)
* Discounts are available only at participating pharmacies. ** You may not receive a savings on some high-volume or maintenance type drug since these medications may have already been reduced at the pharmacy level.
Chiropractic: ~ ~ ~ ~ ~ ~
MORE THAN 7,500 PARTICIPATING DOCTORS. FREE INITIAL CONSULTATION. 50% SAVINGS on all diagnostic services & required x-rays. 30% SAVINGS on treatment and most other services. NO LIMIT on number of visits. TOLL-FREE NUMBER to locate participating network chiropractors.
Different ... and Better?
Hospital Advocacy: Should you need to be hospitalized, and the anticipated charges will exceed $2,500.00, an advocate will be assigned to negotiate the best possible fees for the hospital services. There is a three-day waiting period from the active date of your membership to utilize this program.
AmeriPlan® Auto Club Administered by United States Auto Club-Motoring Divison
Auto Club - There is nothing more frustrating than having trouble with your car while on the road. And if the trouble with the car isn’t enough, you sure don’t want trouble getting immediate assistance. Membership in the AmeriPlan® Auto Club program will give you the service, comfort and savings to lessen your bad experience. Reliable, qualified service providers are available 24/7. The first $50.00 of emergency roadside or towing services will cost you nothing, just sign your name and drive away. Additional charges are discounted by at least 25% off of the retail price. While breakdowns are never fun, this program lessens the pain.
AmeriPlan® Identity Theft Assistance Administered by CLC
Identity Theft - Today, Identity Theft has become a $50 billion problem in the United States. More and more people at all levels of society are becoming victims. What once was a problem for the wealthy has become a problem for all of us. There are two important elements of the identity theft issue that applies to everyone. First is the matter of prevention and second is the matter of resolution after the fact. This CLC Identity Theft Program addresses both of these issues.
AmeriPlan® Legal
CONSUMER HEALTH ALLIANCE
Administered by CLC
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Legal and Financial - Should you have the need to consult an attorney, this program will give you a FREE one hour initial consultation for each occurrence and a 25% discount on any ongoing legal fees. You will also have access to over 4,500 online legal documents, along with a complete legal reference resource.
NurseLine At no cost you can address immediate health matters or get your health questions answered by a licensed registered nurse 24/7. You may save hours lost while waiting in a doctor’s office, missed time from work and even the high cost of office visits.
Podiatry Services: Foot and ankle specialists provide comprehensive management, through medical or surgical methods, of a wide variety of problems that affect foot and ankle function.
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
C H Not Available in South Carolina ONSUMER
EALTH ALLIANCE
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Member in Good Standing
U.S. Chamber of Commerce
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Example of savings on the most utilized dental procedures: Sample General Dentist Procedures*
Dental Office Fees** up to
D0150 - Initial Oral Exam D0120 - Periodic Oral Exam
AmeriPlan® Fees Up To
AmeriPlan® Discount Programs are
AmeriPlan® Savings
NOT INSURANCE!
$118
$37
70
14
69% 80%
D0210 - Intraoral Complete Series 162
65
60%
117
47
60%
174
70
60%
201
95
53%
X-Rays
What makes AmeriPlan Dental Plus™
D1110 - Regular Teeth Cleaning (Light Scaling & Polishing)
Amalgam Fillings (Silver Colored) D2140 - 1 Surface Primary or Permanent
Composite Filling
(Tooth Colored)
D2330 - 1 Surface (Anterior) D3310 - Anterior
D2750 - Porcelain Crown
902
375
58%
1,365
550
60%
5,000 5,500
2,100 2,250
58% 59%
(w/High Noble Metal)
Orthodontic Treatment (Braces) (Invisalign Braces may not be included.) by General Dentist D8080 - Child (under age 19) D8090 - Adult (age 19 and over)
* Current Dental Terminology © 2008 American Dental Association, All Rights Reserved. **National Dental Advisory Service 2008. Different fees may apply in different areas of your state. For the appropriate fees for your area, go to
www.ameriplanusaprovidersearch.com or call 1-800-647-8421.
Example of savings on medical procedures in a general physician’s* office (family physician) and laboratory fees:
~ MORE THAN 30,000 DENTAL PROVIDERS NATIONWIDE. ~ NO LIMIT ON VISITS OR SERVICES. ~ ONGOING DENTAL PROBLEMS ARE ACCEPTED, (Except Dental and Orthodontic ~ ~ ~ ~ ~ ~ ~
INSTANT SAVINGS. NO AGE LIMIT. NO PAPERWORK. NO WAITING PERIOD. ORTHODONTICS (braces) AND COSMETIC DENTISTRY INCLUDED. SPECIALISTS INCLUDED, (where available.) YOU CAN CHANGE DENTISTS.
Vision: ~ MORE THAN 12,000 OPTICAL PROVIDERS NATIONWIDE. ~ SAVE FROM 20% TO 60% on all frames, lenses, tints, scratch-resistant coatings and ultra-violet protection. ~ SAVE FROM 10% TO 50% on ophthalmology eye exams, and LASIK surgery with certain providers in selected markets. ~ SAVE FROM 10% TO 20% ON CONTACT LENSES (excluding disposables) at participating retail locations. ~ SPECIAL SAVINGS FROM 10% TO 40% ON REPLACEMENT CONTACT LENSES. Including daily wear, extended wear, disposable, tinted, bifocals and gas permeable.* ~ ADDITIONAL DISCOUNTS on designer non-prescription sunglasses with the world’s largest online optical store.** ~ 30-DAY UNCONDITIONAL money-back guarantee on all merchandise. ~ TOLL-FREE NUMBER to locate independent and participating chain network providers. * Available through mail order program only. ** Available through Internet program only.
Sample General Physician Procedures* and Lab Sevices
Physician*/Lab AmeriPlan® Fees up to** Fees
New Patient Intermediate Visit Extended Visit Established Patient Limited Visit Intermediate Visit Laboratory Fees Lipid Panel
$187 289
125 189
88
AmeriPlan® Savings
$112 173
75 114
11
40% 40%
Includes ALL of our Health and Dental Programs …
Dental, Vision, Prescription, Chiropractic, Physician, Ancillary Services, Hospital Advocacy, NurseLine, and Podiatry… and More:
87%
37
14
* Specialists’ fees will be slightly higher. ** Physicians fee reference 2008. Different fees may apply in different areas of your state.
62%
Physician: ~ ~ ~ ~ ~ ~ ~ ~ ~
NO WAITING PERIOD. NO PRE-AUTHORIZATION FOR TREATMENT REQUIRED. NO PAPERWORK. INSTANT SAVINGS. SPECIALISTS INCLUDED, WHERE AVAILABLE. MOST ONGOING MEDICAL PROBLEMS ARE INCLUDED. COSMETIC SURGERY INCLUDED, WHERE AVAILABLE. NO AGE LIMIT. YOU CAN CHANGE PHYSICIANS.
Ancillary Services: Includes services such as physical therapy, laboratory procedures, imaging centers, hearing services, mental health services, and diabetic supplies.
Prescription: ~ OVER 56,000 PARTICIPATING RETAIL AND INDEPENDENT PHARMACY LOCATIONS NATIONWIDE* ~ Save 10% - 85% on most brand name and generic prescription drugs** ~ Save on over the counter medications, smoking cessation aids and diabetes supplies ~ Mail order pharmacy option available ~ No cost prescriptions - You may qualify for AmeriPlan's Prescription Advocacy Program. Pharmacy discounts are NOT insurance services or a MediCare Precription Drug Plan and are NOT intended as a substitue for insurance.
40% 40%
(Cholesterol, HDL, LDL, Triglycerides)
CBC (Complete Blood Count)
The COMPLETE package !
Dental:
treatments in progress.)
Root Canal (Excluding Final Restoration)
* Discounts are available only at participating pharmacies. ** You may not receive a savings on some high-volume or maintenance type drug since these medications may have already been reduced at the pharmacy level.
Chiropractic: ~ ~ ~ ~ ~ ~
MORE THAN 7,500 PARTICIPATING DOCTORS. FREE INITIAL CONSULTATION. 50% SAVINGS on all diagnostic services & required x-rays. 30% SAVINGS on treatment and most other services. NO LIMIT on number of visits. TOLL-FREE NUMBER to locate participating network chiropractors.
Different ... and Better?
Hospital Advocacy: Should you need to be hospitalized, and the anticipated charges will exceed $2,500.00, an advocate will be assigned to negotiate the best possible fees for the hospital services. There is a three-day waiting period from the active date of your membership to utilize this program.
AmeriPlan® Auto Club Administered by United States Auto Club-Motoring Divison
Auto Club - There is nothing more frustrating than having trouble with your car while on the road. And if the trouble with the car isn’t enough, you sure don’t want trouble getting immediate assistance. Membership in the AmeriPlan® Auto Club program will give you the service, comfort and savings to lessen your bad experience. Reliable, qualified service providers are available 24/7. The first $50.00 of emergency roadside or towing services will cost you nothing, just sign your name and drive away. Additional charges are discounted by at least 25% off of the retail price. While breakdowns are never fun, this program lessens the pain.
AmeriPlan® Identity Theft Assistance Administered by CLC
Identity Theft - Today, Identity Theft has become a $50 billion problem in the United States. More and more people at all levels of society are becoming victims. What once was a problem for the wealthy has become a problem for all of us. There are two important elements of the identity theft issue that applies to everyone. First is the matter of prevention and second is the matter of resolution after the fact. This CLC Identity Theft Program addresses both of these issues.
AmeriPlan® Legal
CONSUMER HEALTH ALLIANCE
Administered by CLC
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Legal and Financial - Should you have the need to consult an attorney, this program will give you a FREE one hour initial consultation for each occurrence and a 25% discount on any ongoing legal fees. You will also have access to over 4,500 online legal documents, along with a complete legal reference resource.
NurseLine At no cost you can address immediate health matters or get your health questions answered by a licensed registered nurse 24/7. You may save hours lost while waiting in a doctor’s office, missed time from work and even the high cost of office visits.
Podiatry Services: Foot and ankle specialists provide comprehensive management, through medical or surgical methods, of a wide variety of problems that affect foot and ankle function.
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
C H Not Available in South Carolina ONSUMER
EALTH ALLIANCE
PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
Member in Good Standing
U.S. Chamber of Commerce
U.S. Chamber of Commerce
CONSUMER HEALTH ALLIANCE PROTECTING CONSUMER ACCESS TO DISCOUNT HEALTHCARE PROGRAMS
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