Fourstar Dental Plan - Explanation of Benefits

Explanation of Benefits

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EXPLANATION OF BENEFITS

FOURSTAR is not an insurance plan. It is a Special Program made possible through contract relationships with many of the area's caring dentists and specialists who share your concern for the runaway cost of Health Care. THERE ARE NO CLAIM FORMS, NO DEDUCTIBLES AND NO WAITING PERIOD FOR PRE-EXISTING CONDITIONS!

WHO IS ELIGIBLE? Fourstar provides you with the opportunity to join as a single member, couple (2 persons) or as a family. Your dependents are also eligible, including children under age 19 or full-time students up to 23 years of age and unmarried.

WHEN DO MY BENEFITS BEGIN? Fourstar offers you immediate eligibility.
Call (800) 622-8489 FOR IMMEDIATE ELIGIBILITY!

HOW DO I RECEIVE CARE? It's easy! Upon enrollment you will receive a personal membership card or if immediate eligibility is received, you are given a personal identification number. To receive care, simply call the dentist you have selected for an appointment.

PROTECT YOUR FAMILY BY JOINING TODAY! SIMPLY:

Fourstar Dental Plan

COMPLETE THE MEMBERSHIP ENROLLMENT FORM.

SELECT A DENTIST FROM OUR LIST OF PARTICIPATING PROVIDERS.

Fourstar Dental Plan

MAIL, FAX (480) 423-8076 OR E-MAIL YOUR COMPLETED FORM

OR

CALL (800) 622-8489 AND ONE OF OUR FRIENDLY OPERATORS WILL PROCESS YOUR MEMBERSHIP BY TELEPHONE IMMEDIATELY!