About the Foundation
*Please ensure you use adequate postage and keep a copy of the entire application for your records.
**Because of the high volume of applications and need for orthodontic care Winning Smiles Orthodontics acceptance policies are very strict. If your application is incomplete in any way, it will be rejected and returned to you. If you wish to reapply you will be required to submit a new application with an additional $30 application fee.
- Non-parental guardians must also submit a copy of their authorization to make medical decisions.
- For children in state custody, copies of the child's state medical card and medical consent must also be submitted.
TREATMENT FEES: Fees will be determined at the Initial Consultation. Please feel free to print the downloadable New Patient form, Consent for Use and Disclosure form and the Foundation Application. Please mail ALL forms to us COMPLETED or they will be returned and your application will be denied. If applying for the Foundation, these forms must be turned in to us prior to scheduling a New Patient Exam.
*Subjct to a $30 application fee
*All Applications received will be subject to the most current fee structures regardless of the fees specified on the Application submitted.
**Treatment fees include initial records, orthodontic treatment with traditional braces, clear retainers and final records. Additional fees may be charged for other orthodontic devices or appliances required such as a palatal expansion appliance if necessary.
***Basic qualifications for the Foundation include:
- Must be between the ages of 10-25
- Must live in Kent, Muskegon or surrounding Counties
- Must be employed or on Permanent Disability and provide your Federal Tax Returns (1040's) and W-2's or your SSI Awards Letter
- Must be in good Oral Standings
CHARITY CARE PROGRAM: Applicants with severe orthodontic needs and little or no finances are eligible for our Charity Care Program. They are often referred by Social Service Agencies and other nonprofit organizations within the community.
REDUCED-COST PROGRAM: We use a sliding fee scale based on the most recently published Federal Poverty Guidelines.
INSURANCE: We participate with Aetna DMO, Delta Dental Direct, PPO, DMO and EPO and Metlife. *We accept all insurance.
PERSONS WITH ORTHODONTIC INSURANCE COVERAGE : Any additional insurance benefit available will be applied to the discounted portion of the orthodontic treatment fee. We will apply a 10% discount to your portion of the treatment fee once there is an orthodontic insurance payment applied to the account.
PAYMENT PLANS: Payment plans vary based on treatment fees. We will discuss payment plans at the Initial Orthodontic Exam.
NOTE: Winning Smiles Orthodontics provides for orthodontic treatment ONLY. Extractions, cleanings, oral surgery or other treatment that may be necessary before, during or after orthodontic treatment are the financial responsibility of the patient's parents or guardians.