Carefree

D ENTAL

Dental • Vision • Pr
escription

Show your card. Save your money.

Congratulations, and thank you for joining us for your protection against high
health care costs. Download and print your membership card now to start saving.

• Your Carefree Dental card will be activated only after your $15.95 first month
payment is received.

• Your membership ID card may be used by anyone living in your

household. Use as frequently as you wish. There is no limit to how often you
may see a provider — and no annual limit on the money you may save.

• Your member service representative will help you locate participating providers
in any area of the country when you call toll-free 1-800-436-8769. Or visit us
online at CarefreeDental.com.

• Your membership ID card is easy to use. No forms to fill out; no hassles.

Simply show your card at participating providers — even when traveling —for
protection against the high costs of health care services and products.

• You will find benefit details on the enclosed pages. If you have questions or need
to make changes to your membership, please call toll-free 1-800-436-8769,
Monday–Friday, 7:00 am–7:00 pm, CST.

13055-FLW-0416 MEXBMLTCF-A
FAQ ANSWERS TO FREQUENTLY ASKED QUESTIONS

How do I locate a Provider?

Please call Customer Service toll-free at 1-800-436-8769
or visit CarefreeDental.com.

We’ll help you locate a dentist who’s convenient to you. There’s

usually no problem changing dentists, either. This is one of the
largest independent dental care networks nationwide!

What if I have a question or need help?

Simply call toll-free 1-800-436-8769 to speak to a Member Service
representative about the program.

Can anyone in my immediate family use my

membership card?
Yes, anyone living in your household may use your
membership card.

May I locate providers in other communities

if I am away from home?
Yes, a Member Service representative can help you locate
participating providers nationwide. Just have the zip code ready
when you call, and you will receive the information while you
are still on the phone. Or visit CarefreeDental.com.

How do I access my discounts?

When calling to make an appointment or when dropping off your
prescription, please provide the network name to your provider.
• Dental — Aetna Dental Access®
• Vision — Coast to Coast Vision TM

• Pharmacy — Catamaran Rx (present your card)

Present your membership card at your appointment before getting
treatment to assure the proper discount is applied.
 Show your card.
Save your money.
When you make your appointment,
let your dentist know you’ll be using
Save 15% to 50%* per visit, in most instances, your Carefree Dental card — part of
the Aetna Dental Access® network.
on your family dental care expenses. Then simply show your card,
• No forms to fill out. save your money.

• No limit to how often you may see a provider.

Your Carefree Dental card
• No limit to the money you may save. is accepted at more than
161,000* available dental
You and everyone in your household can save money on preventive practice locations nationwide.
and routine dental care and more extensive procedures. If you only
Your Carefree Dental card features
see your dentist twice a year for routine exams, X-rays and cleanings,
one of the largest, independent
the Carefree Dental card can pay for itself with the money you’ll save!
dental care networks in the United
For Example No Plan With Plan Savings* % Saved States. These dentists include
specialists where available:
Oral Exam $62.00 $32.00 $30.00 48%
• General Dentists
Complete X-Rays $152.00 $80.00 $72.00 47%
• Orthodontists
Cleaning $114.00 $63.00 $51.00 45%
• Pedodontists
Filling $185.00 $94.00 $91.00 49%
• Periodontists
Root Canal $823.00 $484.00 $339.00 41%
• Endodontists
Crown $1186.00 $801.00 $385.00 32%
• Prosthodontists
Upper Denture $1341.00 $959.00 $382.00 28%
• Oral Surgeons
*Actual costs and savings may vary by provider, service and geographical location.
*As of August 2015.
We use the average of negotiated fees from participating providers to determine the
average costs, as shown on the chart. Based on Aetna Navigator information 3/20/15.

Locate a participating dentist near

you. Call 1-800-436-8769 toll‑free —
or visit CarefreeDental.com.

This is not a pre-paid plan. This is not insurance. The discount program
provides access to the Aetna Dental Access® network. This network is ad-
ministered by Aetna Life Insurance Company (ALIC). Neither ALIC nor any
of its affiliates offers or administers the discount program. Neither ALIC
nor any of its affiliates is an affiliate, agent, representative or employee of
the discount program. Dental providers are independent contractors and
not employees or agents of ALIC or its affiliates. ALIC does not provide
dental care or treatment and is not responsible for outcomes.
Participating providers may change without notice.
Dental Benefit not available to Washington and Vermont residents.
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Carefree VISION

Save 10% to 60% on vision care expenses.

Show your card. Save your money. Your membership card is
accepted by more than 20,000 vision care professionals nationwide.
When you make your appointment, let your provider know you’ll be using
your Carefree Dental card ­— part of the Coast to Coast Vision™ network.
Then simply show your card, save your money. Save 10% to 40% on mail order
Contact Lenses.
To locate any providers near you, call toll-free 1-800-436-8769, or visit • Members can purchase disposable
our web site at CarefreeDental.com. contact lenses by mail order. Call
1-800-878-3901 to get a price
Use your vision program as often as you wish — for yourself and quote over the phone...tell the
everyone in your household. No forms to fill out. No hassles. operator the brand and type of
lens you’re interested in. The
No annual limit on the money you can save. Includes common operator will assist you in the
vision care needs, such as: ordering process.
• Eye Examinations, where available. • E-mail or fax a valid doctor’s
• Eye Glasses — most frames and lenses. contact lens prescription
• Tints, Scratch-Resistant Coatings and Ultra-Violet Protection. to America’s Eyewear at
americaseyewear@newbenefits.
• Contact Lenses com or fax 972-503-5671. Be
• Surgical Procedures, including Lasik where approved and available. sure to include your name and
membership number from your
For Example No Plan With Plan Savings* % Saved membership card. You may place
orders as often as you wish prior
Regular Eye Exam – OD $91.67 $79.25 $12.42 14% to the expiration date of the
prescription.
Single Vision Lenses $95.67 $70.43 $25.24 26%
• Most orders are received within 7 to
Designer Frames $194.33 $144.20 $50.13 26% 14 days and can be paid for by Visa,
MasterCard, money order or check.
Progressive Lenses $259.33 $191.53 $67.80 26%
Save 15% to 40% on mail order
*Savings are examples. Actual savings vary based on area and provider.
through FramesDirect.com.
Low Price Guarantee: If you purchase prescription eyeglasses at a
Choose from over 100,000 frames from
participating location, and you find a lower price anywhere else within
top name brands. Save either 40% on
30 days, the difference will be cheerfully refunded.
lenses for eyeglasses or sunglasses
when ordering online using the promo
30-Day Unconditional Guarantee code NB40LENS, or save 15% off your
entire order through FramesDirect.
If for any reason you are not happy with a purchase at
com using NB15OFF (excludes contact
a participating location or through the mail, return the lenses and certain brands of eyewear
merchandise within 30 days for an exchange or full refund. due to manufacturer guidelines).
Includes free standard shipping for
May not be used in conjunction with other discounts or insurance. orders over $99. Must include group
Vision Benefit not available to Vermont residents. code FRAMES at checkout process to
This is not insurance. validate your purchase.
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Carefree PRESCRIPTION

Save 10% to 85% on prescription drugs.

• Brand name medicines
• Generic medicines

Use your prescription drug program as often as you wish for yourself

and everyone in your household.

For Example No Plan With Plan Savings* % Saved

Simvastatin, Tab 20mg $18.84 $7.28 $11.56 61%

Lisinopril, Tab 40mg $14.08 $9.35 $4.73 34%

Amlodipine, Tab 10mg $26.68 $7.26 $19.42 73%

Azithromycin, Tab 250mg $27.84 $13.33 $14.51 52%

Show your card.
Omeprazole, Cap 20mg $24.62 $13.09 $11.53 47%
Save your money.
Pantoprazole, Tab 40mg $68.32 $12.94 $55.38 81% Your membership card is accepted
by more than 65,000 pharmacies
*Savings are examples. Actual savings vary based on area and provider.
nationwide. Present your member­
ship ID card when dropping off your
prescription.
To find a participating pharmacy near You can save money at independent
you, call toll-free 1-800-436-8769, pharmacies — and major chain drug
stores, too, including:
or visit CarefreeDental.com.
Albertsons Safeway
CVS Target
Always Get the Lowest Price Costco Vons
Find out which participating pharmacy has the best price. Compare prices Kmart Walgreens
online at mycatamaranrx.com/cashcard. When dropping off your prescription, Kroger Wal-Mart
present your membership ID card, and let your pharmacy know you’ll
Meijer Winn-Dixie
be using the Carefree Dental card ­— part of the Catamaran Rx network.
Rite Aid and more...

Mail Order Convenience

Members can also obtain a mail order form at mycatamaranrx.com/cashcard
under the Additional Info tab.

Note: This benefit cannot be used in conjunction with any other prescription drug
discount program or insurance. While our provider lists are continually updated,
provider status can change. We recommend that you confirm the provider you
selected participates in the program before dropping off your prescription.
This is not insurance.
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 Terms, Conditions and Disclosures
This plan is not insurance. This is your agreement as Cardholder with Coverdell &
Company, Inc. (a "discount medical plan organization," "DMPO"). It is effective on the
date of acceptance of Cardholder’s application for enrollment in the Carefree Dental
(“Program”) and for the period of your plan.
Limitations, Exclusions & Exceptions. DMPO shall provide Cardholder with a
listing of participating providers. Providers are subject to change without notice.
Cardholder is responsible for choice of provider, verification that the provider is a
current participant and for payment for goods and services. No portion of any
provider’s fee will be reimbursed or otherwise paid by Coverdell. You are solely
responsible for payment. Savings are based on the provider’s usual fees or on
national or regional fees for the service or product. Actual savings will vary
depending upon Your location and the specific products or services purchased.
Providers may offer certain products or services to the general public at prices lower
than the Program price. In that event, members will always be charged the lower
price. This is a discount program and not insurance. Program discounts cannot
be used in conjunction with any other network based program.
Although DMPO screens participating providers to ensure appropriate credentials
and qualifications to provide goods and services, DMPO does not otherwise
guarantee nor is responsible for the quality of such service or product purchased by
Cardholder. Coverdell reserves the right to modify any benefits included in Your
Program, but will make every attempt to replace any benefits with a comparable
benefit. If your state requires that we notify you of changes to your benefits,
Coverdell will do so.
Payment of membership fee is made by the billing source authorized by You in
accordance with the payment terms to which You agreed. DMPO reserves the right
to increase or decrease the membership fee for each renewal membership term
effective upon renewal of Your membership. To change your method of
payment, call the customer service number on your membership I.D. card.
Membership is not transferable. You have a family membership, only you and
anyone living in your household may use this membership. Should a single
member wish to add family members on a family plan, call the customer service
number shown on the membership I.D. Card.
General Complaint Procedure. Complaints of any nature may be filed with
Coverdell & Company, Inc. the discount medical plan organization at 8770 W. Bryn
Mawr, Suite 1000, Chicago, IL 60631. Complaints will be acknowledged in writing
within 5 business days and will be resolved in writing to you within 30 calendar days.
Should you remain dissatisfied with the results from your complaint with the discount
medical plan organization, you may contact the Commissioner of Insurance, Division
of Insurance, the insurance department, or other agency which regulates this product
in your state. Contact us at 1-800-436-8769 to obtain state complaint contact
information.
Termination and Cancellation. You may terminate Your membership at any time
by logging in to carefreedental.com and submitting a cancellation request on the
Contact Us page, calling us at the toll free number on Your membership card, or You
may notify us in writing at Member Services, 8770 W. Bryn Mawr, Suite 1000,
This is not insurance
MEXCFTCFL-C (0617)
Chicago, IL 60631.Your cancellation will be effective promptly upon the receipt of
Your cancellation notice and You will no longer be billed for Your membership.
All Members: You have the right to cancel this plan within 30 days after the
effective date for a full refund of fees paid.
Annual Members Only: After the first 30 days, if a membership is cancelled by You or
DMPO for any reason other than nonpayment of fees, You are eligible for a pro-rata
refund of membership fees.
Governing Law and Arbitration. Your membership is governed and controlled by
the laws of the State of Illinois. Any dispute arising from or related to Your
membership shall be resolved by binding, non-appealable private arbitration
conducted in accordance with the Rules of American Arbitration Association in
Chicago, Illinois, unless required by a member’s individual state laws to resolve in a
different location. This provision shall survive the termination of Your membership
and shall be subject to the Federal Arbitration Act.
Governing Law and Arbitration for Montana Residents. Your membership is
governed and controlled by the laws of the State of Montana. Any dispute arising
from or related to Your membership shall be resolved by a voluntary private
arbitration conducted in accordance with the Rules of the American Arbitration
Association in the State of Montana. This provision shall survive the termination of
Your membership and shall be subject to the Federal Arbitration Act.
South Dakota Residents. If you cancel the program you are not obligated to
make any further payments under the program, nor are you entitled to any
benefits under the program for any period of time after the last month for which
payment has been made.
Disclosure. This plan is NOT insurance. This plan is not a
qualified health plan under the Affordable Care Act (ACA). Some
services may be covered by a qualified health plan under the ACA.
This plan does not meet the minimum creditable coverage
requirements under M.G.L. c. 111M and 956 CMR 5.00.This is not
a Medicare prescription drug plan. The plan provides discounts at
certain health care providers of medical services. The plan does not
make payments directly to the providers of medical services. The
plan member is obligated to pay for all health care services but will
receive a discount from those health care providers who have
contracted with the discount medical plan organization. The range
of discounts will vary depending on the provider type and services
provided. The licensed discount medical plan organization is
Coverdell & Company, Inc. at 8770 W. Bryn Mawr, Suite 1000,
Chicago, IL 60631, 1-800-436-8769. To view a list of participating
providers visit carefreedental.com. You have the right to cancel
this plan within 30 days after the effective date for a full refund
of fees paid. Such refunds are issued within 30 days of
cancellation.

This is not insurance