8 Reasons You Can Get Farther Ahead Without Relying on Dental Insurance


Take control of your dental care.

The idea of insurance is that you pay a small monthly cost in exchange for financial coverage you may potentially need in the future. For instance, you have auto insurance on your car so that if something happens to your vehicle, your insurance will reimburse you if the repairs fall within their guidelines for coverage.

But does this same idea apply to your dental insurance? The answer might surprise you. In fact, the idea of dental insurance as a whole is worth questioning before you sign up or renew your coverage.

Here are eight reasons dental insurance could be a hindrance instead of a help.

1. Dental insurance doesn’t really work like typical “insurance.”

Most dental insurance plans are actually dental benefit plans in disguise. Instead of reimbursing you for expenses, your provider provides coverage (benefits) for specific services and only up to a set amount. Finding out the truth can be a rude awakening, especially in a dental emergency. If you need a procedure that isn’t covered or you’ve already reached your maximum, you’re out of luck.

2. Dental insurance coverage isn’t always transparent or easy to understand.

Trying to understand dental insurance coverage isn’t easy. Some providers make it difficult for the average person to figure out what is and isn’t covered and up to what amount. Worse yet, there can be a lot of strings attached, hidden in the fine print.

With a private dental membership, there is no confusing legal jargon or hidden meanings. You’ll know exactly which services are covered for free, which aren’t, and any discounts you can receive on dentistry services.

3. Annual costs for insurance can amount to more than you would have paid out of pocket.

Patients with optimal oral health or relatively few dental issues can wind up paying more in insurance than they would have paid out of pocket. This is truly unfortunate, especially when you’ve been led to believe that insurance will always save you money.

Private dental memberships, like the one Tomasik offers, have a set annual fee and free preventive care included in the cost. You only pay for what you need, rather than a random figure pulled from statistics of average costs.

4. Major dental expenses with a high cost may not be covered by dental insurance.

If you’re facing a significant dental expense, such as a full-mouth restoration, your insurance might not cover it. Or worse, you’ll agree to an extensive procedure only to find out that your insurance maximum was met and you’re now facing a surprise bill you didn’t anticipate.

When you have private dental membership, your dentist will explain the financial coverage of your dental care upfront. You will never be surprised by a massive bill.

5. Your dental insurance provider might make you wait to get treatment.

Imagine you need dental care to fix a tooth, your insurance coverage includes the treatment you need, but then you’re told you need to wait. Unfortunately, this is a genuine problem many people face. For one reason or another, you could have to wait a few months or even a year before getting the care you need.

With private dental membership, there is no waiting. As soon as your dentist discovers that you have a bad tooth or another issue, you’ll be ready for treatment as soon as they can book your appointment.

6. Many dental insurance plans have an annual maximum that doesn’t reflect modern dental care needs.

Dental insurance plans have notoriously low maximums compared to what dental care costs in today’s world. Although dentists do their best to keep care affordable, prices have increased compared to 10 or 20 years ago.

Sadly, insurance providers rarely increase their maximums to reflect this. The result is patients who run out of financial coverage, even though they are far from needing any sort of extreme or extensive care.

Private dental memberships don’t have a maximum. Instead, you’ll receive a discount on the services you need, no matter the final cost.

7. What’s considered necessary for your oral health can be denied or downcoded.

Some dental care procedures are necessary, like a root canal and crown, but this isn’t always the case. Say, for instance, you want a dental implant to replace a front tooth. The agent reviewing your request may deny coverage because they don’t personally believe it to be necessary for the function of your smile. You’re now stuck paying out of pocket for the implant or skipping treatment altogether.

Similarly, “downcoding” or alternative benefit clauses are something insurance providers do to lower costs on their end. Again, using dental implants as an example, your provider may refuse to cover implant-supported dentures and instead provide coverage for traditional dentures. Unless you accept this alternative treatment, you’ll have to pay out of pocket for implants.

With a private dental membership, you and your dentist are the only ones involved in these crucial decisions.

8. Even the best dental insurance plans can’t be personalized to meet your needs as a patient.

The fact of the matter is that dental insurance requires you to work within its limitations. There’s no regard for modern advances in “standard of care” or your personal needs as a patient. A private dental membership is the only way to truly get personalized financial support.

Sign up for a Tomasik Dental Membership Plan today!

If you’re currently uninsured or coming up on your insurance renewal date, consider skipping private dental coverage. You can take control of your oral health and finances by signing up with Tomasik Family Dental instead.

The Tomasik Dental Membership Plan is available for individuals and families. As a member, you’ll receive free biannual exams and cleanings, free annual X-rays, free whitening for adult members, free fluoride treatment for youth members, and an additional 10% discount on most dental care services! How does it work? You sign up and pay your annual fee … and that’s it! No deductibles, no maximums, and no waiting periods for treatment.

Learn more about the Tomasik Dental Membership plan by calling our Bee Cave, TX office or sign up now using our online portal.