Plan

Info

Family

Pay

Choose Your Plan

Select the dental plan that best fits your needs. All plans include immediate coverage with no waiting period.

Elite Plan

Comprehensive coverage with premium benefits

Individual $39.75/mo

Couple $49.75/mo

Family $59.75/mo

Core Care Plan

Great coverage for everyday dental needs

Individual $19.75/mo

Couple $29.75/mo

Family $39.75/mo

Your Information

Tell us about yourself to get started with your dental coverage.

Are you enrolling a minor child?

Check this if you are a guardian or responsible adult (18 or older) enrolling a child on the plan. Enter your own information below, including your own date of birth — you are the responsible party and will not be added to the plan as a covered person. You will add the minor child as a dependent in the next step.

Yes, I am enrolling a minor child as the guardian / responsible adult.

Personal Details

First Name

Middle Initial

Last Name

Email Address

Language Preference

Date of Birth

Gender

Marital Status

Contact Information

Mobile Phone

Home Phone

Work Phone

Home Address

Address Lookup

Street Address

Apt/Suite/Unit

City

State

Zip Code

Family Members

Add family members to your plan (optional).

Review & Pay

Review your enrollment and complete your secure payment.

Plan Details

Selected Plan -

Coverage Type Individual

Monthly Premium $0.00

One-Time Setup Fee $0.00

Amount Due Today $0.00

Next Payment Date -

Primary Member

Name -

Email -

Phone -

Family Members

Recurring Payment Authorization

I authorize United Elite Dental Care to charge my card on a recurring monthly basis for my dental plan premium.

Payment Information

Secured by Square

Card Details

Name on Card

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Welcome to United Elite Dental Care!

Your enrollment is complete. A confirmation email has been sent with your membership details.

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