Yes. If you have dental insurance, you can use it here.
We are not in any plan’s network, which changes one thing: your insurer sends the reimbursement to you instead of to us. We still file the claim on your behalf, exactly as an in-network office would. For most people with a PPO — which is most people — that is the entire difference.
There is one exception, and it’s worth knowing which side of it you’re on before you book. That’s the next section.
How to tell whether your plan will reimburse you
Call the number on your insurance card and ask one question: does my plan have out-of-network benefits?
That single answer tells you what you need to know. If you’d rather not call, the type of plan usually settles it.
Plans that will reimburse you here:
- PPO (DPPO) — the most common type by far. You can see any licensed dentist, and the plan pays a percentage of the fee, usually a somewhat lower percentage out of network, up to your annual maximum.
- Indemnity — sometimes called a traditional or fee-for-service plan. There is no network at all; it pays a percentage of any dentist’s fee. Less common now, and the most flexible coverage there is.
- POS (DPOS) — a hybrid. You keep the freedom to go outside the network, typically at a reduced rate.
Plans that generally will not:
- HMO (DHMO) and other capitation plans — your insurer pre-pays an assigned in-network dentist a fixed monthly amount for every patient on their list, whether or not you come in. Because the plan doesn’t reimburse procedure by procedure, the American Dental Association notes that patients generally have to be treated at a contracted office to receive any benefit at all. If you carry a DHMO, your benefit stays with the office you’re assigned to.
- EPO (DEPO) — exclusive-provider plans require in-network care, with narrow exceptions for certain emergencies.
- Discount or dental savings plans — these aren’t insurance. They’re memberships that give you a price break at participating offices, so there’s no claim to file and nothing to reimburse.
- Medicaid and similar public programs — these pay only dentists enrolled with the program.
If your plan is in that second group, you’re still welcome here, and plenty of our patients are in exactly that position. It just means you’d be paying without reimbursement, and you should know that going in rather than afterward. Ask us and we’ll help you make sense of whatever your insurer tells you.
What happens at the visit
You pay for your care before or at the time of service. We file your claim afterward, and your insurer sends its share to you.
That order works in your favor more than it might sound. Nothing waits on an insurance company — your treatment isn’t held up while a claim processes, and you’re never in the position of having a tooth on hold while two offices exchange paperwork.
What we can’t do is promise the outcome.
We file the claim; your insurer decides what to pay, and that decision rests on the terms of your specific policy — your annual maximum, waiting periods, frequency limits, exclusions, and how they choose to classify a procedure. If a claim comes back denied or underpaid, we’ll resubmit it once. Past that, the appeal is between you and your plan, and we’ll give you whatever documentation you need to pursue it.
We’d rather say that plainly now than have you find it out from an explanation of benefits three weeks later. Your policy is a contract between you and your insurer. We aren’t a party to it, and we can’t make them honor it.
Why your benefits run out before your treatment does
This is the part that surprises people, and it has nothing to do with our office. It’s worth understanding whichever dentist you see.
Your dental plan has an annual maximum — typically between $1,000 and $2,000. Once you reach it, the plan pays nothing more until the year resets.
That’s the opposite of how your medical plan works. Medical coverage has an out-of-pocket maximum, and it exists to protect you: past a certain point, the insurer covers everything. A dental annual maximum caps what the insurer pays. One number is a floor under the patient. The other is a ceiling over the company. They’re built for opposite purposes and happen to share a name.
The number is also old. Dental insurance began in 1954, negotiated by West Coast dock workers as a union benefit, and by the 1960s a typical plan capped out around $1,000 a year. For the era, that was real coverage — this practice opened in 1968, and $1,000 handled a meaningful amount of dentistry.
It has barely moved since. Roughly a third of in-network PPO plans still cap between $1,000 and $1,500, the same range as fifty years ago. Adjusted for inflation, $1,500 in the early 1970s carries the buying power of somewhere around $9,000 to $10,000 today. In 2024 the American Dental Association adopted a formal position opposing annual and lifetime maximums in dental benefit programs, on the grounds that out-of-pocket costs have become a real barrier to care.
Most people never notice, because most people never reach their cap. It’s invisible right up until the year you need something significant.
Here’s what that looks like in practice. Break a front tooth and an implant with a crown may be the right answer; your plan pays out its same $1,000 or so whether the actual cost is $1,000 or $8,000. Need a root canal, a buildup and a crown on one tooth? That’s a routine clinical sequence, and it exhausts most annual maximums by itself.
Imagine homeowners insurance built the same way. Your house burns down and the policy pays a flat $1,500 — but it will happily chip in for window cleaning twice a year. Nobody would call that insurance. We’d call it a maintenance plan, which is a fine thing to have, as long as you don’t mistake it for a safety net.
Dental coverage is a maintenance plan, and it’s genuinely good at maintenance. Most plans cover cleanings, exams and X-rays at or near 100%, and that is the highest-value dentistry there is. If your employer pays the premium, use it. The mistake isn’t having a plan. It’s assuming it will be there when something serious happens, and letting its ceiling decide what care you’re allowed to consider.
What we do when the plan won’t carry it
Because we know the cap is going to run out on any substantial case, we built the payment side around that rather than around the insurance company.
- The Optimal Dental Health Program. Prepay a full year of hygiene visits, exams and X-rays at a discount off our regular fees — plus 10% off most treatment, from whitening to a crown, with no minimum. It’s a savings benefit for our patients, not an insurance product, and it doesn’t matter whether you carry coverage.
- 5% off for paying in full up front, on treatment plans of $1,000 or more.
- Outside financing if you want it. CareCredit and Cherry are both available, and you can check your pre-approval before your visit with no obligation. We don’t push financing — it’s there to remove a barrier, not create one.
- Phased treatment. Large cases can be sequenced over years to fit your budget. Several of the transformations in our case gallery were done exactly that way.
The point of all four is the same: the plan should be built around your case and your budget, not around what an insurance company is willing to put on the table this calendar year.
Should you buy your own policy?
If an employer pays your premium, take it. That’s free money.
If you’re writing the check yourself, do the arithmetic first. An individual plan generally runs somewhere between $20 and $60 a month — call it $240 to $720 a year — usually on top of a deductible, and it typically caps out between $1,000 and $2,000.
Then there are the waiting periods. Most individual plans won’t pay toward a filling for around six months, or toward a crown for a full twelve. So in the first year, the coverage you’d actually want isn’t available yet, and what is covered is largely the preventive care your premiums have roughly paid for anyway.
That isn’t an argument against dental insurance across the board. In a year that brings a root canal and a crown, a policy you’ve already held for a while can genuinely come out ahead. But if your needs are routine and you’re paying the premium yourself, run the numbers before you assume a policy is the answer. We’re happy to help you think it through, and we don’t have a stake in which way you go.
Why our office is set up this way
Some patients want to know the reasoning, so here it is briefly.
Signing a network contract means accepting that insurer’s fee schedule, and that has two effects that reach past billing.
It sets the fees, which sets the time. To charge less, a practice has to see more people in less time. That isn’t a character flaw, it’s arithmetic. Our appointments run an hour, and up to 90 minutes for a new patient exam, and we can only do that because nobody else is setting our fees.
And benefit years create a clock that has nothing to do with your mouth. When coverage resets every January, “use it before you lose it” quietly enters the treatment conversation, and treatment gets sequenced around a plan year instead of around what’s actually urgent.
Plenty of excellent dentists take insurance and treat their patients well. The point isn’t that network participation makes someone a bad dentist. It’s that it introduces pressures we’d have to actively resist, and we’d rather build the practice so they never show up in the room.
The short version
You’re responsible for payment, and your plan is a coupon that reduces what you end up paying. It’s a welcome one, and we’ll do the paperwork so you actually get it. But a coupon isn’t a party that owes anyone anything, and whether it comes through doesn’t change what the treatment costs. Knowing that from the start is the difference between a treatment plan you finish and one that stalls halfway.
Questions about how this works for your situation? Call us at 702-734-0776 and ask. We’ll give you a straight answer before you ever sit in a chair.