Checklist: What to Include in Your Membership Plan Terms and Conditions
Clear terms and conditions are essential for every successful in-office membership plan. They provide structure, protect your practice legally, set clear expectations for patients, and prevent confusion. Most importantly, they help build trust by ensuring transparency in how your plan works.
To help you strengthen your plan, here are the key elements every practice should include in their membership plan’s Terms and Conditions:
1. Plan Eligibility
Establishing who can join your membership plan is the foundation for a clear and compliant program. This section eliminates confusion and ensures the plan applies only to the intended patients. Be sure to define:
● Who can join (patients without insurance, all patients, or specific groups).
● Age requirements (adult vs. child plans).
● Residency or practice-specific restrictions, if any.
2. Membership Fees and Payment Terms
Being upfront about fees and payments builds patient confidence and reduces billing issues. This section should make payment expectations simple and transparent. Here’s what to include:
● Membership cost (monthly, bimonthly, quarterly or annually).
● Accepted payment methods (credit card, ACH, etc.).
● Automatic renewal policy and renewal date terms.
● Grace periods or late payment policies.
3. Services Included in the Plan
Patients should always know what their membership covers. Clearly outlining included services helps patients understand the value of their plan and ensures consistency in care delivery. Make sure to clarify:
● Preventive services covered (cleanings, exams, X-rays, etc.).
● Frequency (e.g. two cleanings per year).
● Discounts on additional services (fillings, crowns, cosmetic treatments, etc.).
● Any limitations on discounts.
4. Services Excluded from the Plan
Transparency about what’s not included helps avoid misunderstandings. Defining exclusions early ensures patients know what services fall outside the plan. Clearly outline what isn’t part of your membership plan, such as:
● Specialist referrals
● Lab fees, orthodontics (if not included)
● Sedation
5. Discounts and How They Apply
Discounts are a major benefit for patients, but they must be clearly defined to prevent confusion. This section ensures everyone understands how and when discounts apply. Be sure to specify:
● Percentage off for restorative or cosmetic procedures.
● Whether discounts apply to elective treatments (e.g. whitening).
● That discounts cannot be combined with other offers or insurance.
6. Membership Duration and Cancellation
Defining how long the membership lasts and what happens if a patient cancels provides clarity for both sides. Clear policies protect your practice’s revenue and reduce administrative issues. Make sure to include:
● Membership period (usually 12 months from enrollment).
● Cancellation/refund policy (no refunds after benefits are used, pro-rated refunds if unused, etc.).
● Conditions under which the practice can terminate the membership (missed payments, misuse, etc.).
7. Renewal Process
Renewals are key to maintaining long-term memberships. Explaining how renewal works prevents unwanted charges and helps manage expectations. Include details such as:
● Automatic renewal notice requirement.
● How patients can opt out prior to renewal.
● Renewal fees and whether they can change annually.
8. Non-Insurance Disclaimer
A clear disclaimer helps patients understand that your plan is not a substitute for dental insurance. It also keeps your practice compliant with regulations. Be sure to state:
● “This is not dental insurance.”
● Membership plans cannot be combined with insurance benefits.
● The plan only applies to services provided at your practice.
9. Patient Responsibility
Setting expectations for patient responsibilities creates accountability and a smoother experience. Patients should understand their role in keeping their membership active. Clearly communicate:
● Patients are responsible for scheduling their appointments.
● Services not used within the plan year may not roll over (unless otherwise stated).
● Patients must keep account information up to date for billing.
10. Legal and Compliance Language
Including legal and compliance language safeguards your practice and ensures your plan follows all applicable laws. This section serves as the foundation for protecting both your practice and your patients. Be sure to include:
● HIPAA and data privacy notes.
● Jurisdiction and governing law (state-specific if needed).
● Liability disclaimer.
Clear, well-written terms and conditions are vital for protecting your practice, avoiding misunderstandings, and building trust with patients. When written effectively, they create transparency and a strong foundation for long-term patient relationships.
Dental Menu helps practices structure membership plans, maintain compliance, and manage renewals seamlessly. Contact us today to see how we can simplify and safeguard your plan management.
