Enroll Dental Plans, Dental Plan Sign Up, Dental Discount Care

Member Information

Full Name:

Phone Number:		Email:

Billing Address

Street Address:

City:

State:		Zip Code:

Member Enrollment Plan Summary

	Annual Family:	$199.95 / Year (SAVE 4 MONTHS!)
	Monthly Family:	$24.95 / Month

Your first payment includes a processing fee of $25, which is non-refundable except in AR, MD, RI and TN.

30-Day Money Back Guarantee

Our dental plans carry a 30-day money back guarantee. If you are not fully satisfied within the first 30 days, we will be happy to refund your membership fees.¹

Why Select a Discount Dental Plan

•	Easy to Use and affordable.
•	Quick Plan Activation. No Paperwork Hassles.
•	Exclusive member-only savings on dental care.
•	Save on pre-negotiated dental procedures.
•	100% satisfaction guaranteed.

Do you have Questions?

If you would like to speak to a dental care specialist simply call the number shown below.

1-800-272-1509

Secure Credit Card Payment Information
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Credit Card Number:

Expiration Date: (Month / Year)

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All credit card transactions through this website are guaranteed to be safe and secure.

Your first payment includes a processing fee of $25, which is non-refundable except in AR, MD, RI and TN.

Disclosures: The discount medical, health, and drug benefits of this Plan (The Plan) are NOT insurance,a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members’ payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment and supplies from providers in The Plan. The Discount Medical Plan Organization/Discount Plan Organization is Alliance HealthCard of Florida, Inc., 5005 LBJ Freeway, Suite 1500, Dallas, TX 75244. You may call 800-565-3827 or email info-abs@member-questions.com for more information or visit the provider link for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement. The Plan includes a 30-day cancellation provision.

Note to MA consumers: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.

Not available in AK, MT, ND, OK, RI, SD, TN, UT, VT, WA, WY. Medical discounts provided by Alliance HealthCard of Florida, Inc.