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Benefit Summary

Affordable Smile Plan MCDP Standard Fee
Periodic Oral Exam 100% $63.00
Limited Oral Exam 100% $94.00
Comprehensive Oral Exam 100% $109.00
Comprehensive Periodontal Exam 100% $120.00
Full Mouth X-Rays 100% $156.00
Panoramic X-Ray 100% $131.00
Bitewing X-Rays – 4 films 100% $80.00
Bitewing X-Rays – 2 films 100% $54.00
Dental Cleaning – Adult 100% $109.00
Dental Cleaning – Child 100% $81.00
Fluoride Treatment 72% $53.00
Tooth Colored Fillings 51% $351.00
All Porcelain Crowns 34% $1373.00
Core Buildup 56% $323.00
Root Canal Therapy 53% $1,242.00
Deep Scale Cleaning 51% $307.00
Dentures 50% $2,264.00
Partials 50% $2,187.00
Surgical Extraction 43% $335.00
Orthodontia – Child* $3,400.00 $6,033.00
Orthodontia – Adult* $3,400.00 $6,177.00
Individual Plan $129.00**
Family Plan (up to 4 family members) $199.00**

All services not listed are discounted 20% off of Standard fees
*Price valid for traditional braces only, does not include Invisalign
**No refunds on the purchase of the Affordable Smile Plan will be given once services have been provided at the discounted rate.

Affordable Smile Plan MCDP – E Standard Fee
Periodic Oral Exam 100% $63.00
Limited Oral Exam 100% $94.00
Comprehensive Oral Exam 100% $109.00
Comprehensive Periodontal Exam 100% $120.00
Full Mouth X-Rays 100% $156.00
Panoramic X-Ray 100% $131.00
Bitewing X-Rays – 4 films 100% $80.00
Bitewing X-Rays – 2 films 100% $54.00
Dental Cleaning – Adult 100% $109.00
Dental Cleaning – Child 100% $81.00
Fluoride Treatment 100% $53.00
Tooth Colored Fillings 71% $351.00
All Porcelain Crowns 49% $1,373.00
Core Buildup 73% $323.00
Root Canal Therapy 62% $1,242.00
Deep Scale Cleaning 67% $307.00
Dentures 60% $2,264.00
Partials 63% $2,187.00
Surgical Extraction 64% $335.00
Orthodontia – Child* $3,400.00 $6,033.00
Orthodontia – Adult* $3,400.00 $6,177.00
Individual Plan $349.00**
Family Plan (up to 4 family members) $399.00**

All services not listed are discounted 30% off of Standard fees
*Price valid for traditional braces only, does not include Invisalign
**No refunds on the purchase of the MetroCare Dental Discount Plan will be given once services have been provided at the discounted rate.

Plan Exclusions:

  • Treatment of fractures or dislocations, congenital malformations, malignancies, cysts or neoplasms, or TMJ
  • Prescription drugs and over-the-counter drugs

Plan Limitations

  • Full mouth x-rays are limited to once every 24 months
  • Replacement of partial denture is limited to once every five years
  • Full upper and/or lower dentures are not to exceed once each in any five-year period
  • Denture relines are limited to one per arch in any 12 month period.
  • Services performed by a non-participating provider are not covered.