Investing in Your Oral Health
Most people do not plan for complex dental treatment years in advance.
A failing dentition, significant tooth wear, multiple missing teeth, or the need to replace older dental work can result in a treatment plan that is considerably more extensive than a routine filling or crown. For patients considering dental implants, extensive restorative treatment, or full-mouth rehabilitation, the financial commitment can be significant.
Cost is therefore an important part of treatment planning, and it is a conversation worth having openly.
At Buxmont Prosthodontics & Restorative Dentistry, Dr. Wang and Dr. Chernow believe that patients should understand not only their treatment options, but also the financial considerations associated with those choices.
For complex cases, there may be more flexibility than patients initially realize. Treatment can sometimes be phased over time, dental benefits may reimburse a portion of care, tax-advantaged HSA or FSA funds may be available, and our practice can arrange interest-free payment plans in appropriate situations.
The important point is that financial planning should be considered alongside clinical treatment planning from the beginning.
Why Dental Insurance May Cover Only a Portion of Complex Treatment
The term “dental insurance” can create expectations that do not always match how dental benefit plans actually work.
Most dental plans are designed primarily to help with routine and relatively limited dental expenses. They typically have annual maximum benefits, exclusions, frequency limitations, waiting periods, and restrictions on particular procedures.
That model can work reasonably well for preventive care and smaller restorative needs. It is often less compatible with the type of treatment provided in a prosthodontic practice.
Patients who require multiple crowns, dental implants, replacement of failing restorations, rehabilitation of a worn dentition, or comprehensive reconstruction may have treatment needs that substantially exceed the annual benefit provided by a typical dental plan.
In other words, having dental insurance does not necessarily mean that complex dental treatment will be largely paid for by insurance.
It is more useful to think of many dental plans as a benefit that may offset part of the cost of treatment, rather than comprehensive insurance against a major dental expense.
Why Buxmont Prosthodontics & Restorative Dentistry Is Out of Network
Buxmont Prosthodontics & Restorative Dentistry is not in network with dental insurance companies. This is an important distinction, and we believe patients deserve to understand why.
Our treatment recommendations are based on our clinical evaluation, the patient’s goals, and what Dr. Wang and Dr. Chernow believe will provide an appropriate and predictable result. In complex prosthodontic care, those decisions may involve treatment sequencing, restorative materials, laboratory procedures, provisional restorations, dental implants, occlusion, esthetics, and long-term maintainability.
Insurance contracts are designed around a different set of considerations. A dental benefit company determines which procedures it will reimburse, how often it will reimburse them, and how much it is willing to pay toward those procedures.
Those decisions do not necessarily reflect what is clinically ideal for an individual patient.
We believe excellent dental care is built primarily on the doctor-patient relationship. The patient and doctor should be able to discuss the available options, weigh their advantages and disadvantages, and choose treatment based on the patient’s circumstances without allowing a third-party payer to determine the treatment plan.
Being out of network does not mean patients with dental insurance cannot receive benefits.
Our team can submit claims to dental insurance companies on behalf of our patients so that they can receive any out-of-network reimbursement available under their individual plans. The amount reimbursed varies considerably by plan, and we cannot determine what an insurance company will ultimately pay.
When benefits are available, we want our patients to receive them. We simply do not believe that insurance coverage should determine what treatment is recommended.
Complex Prosthodontic Treatment Does Not Always Fit the Insurance Model
This becomes particularly important in comprehensive treatment.
Consider a patient with severely worn teeth, multiple failing restorations, missing teeth, and an unstable bite. Proper treatment may involve diagnostic records, digital planning, provisional restorations, crowns, implants, laboratory procedures, and careful sequencing over an extended period.
An insurance company evaluates many of those procedures individually according to the terms of the patient’s contract.
A prosthodontist has to evaluate them as parts of one treatment plan.
That difference matters.
The appropriate sequence may not correspond neatly to an insurance company’s calendar year. A particular material or procedure may be selected because it makes sense clinically even if the patient’s plan provides little or no reimbursement for it. Treatment may also require procedures that exceed an annual dental benefit relatively early in the process.
For this reason, insurance coverage is one financial consideration in complex treatment, but it should not be confused with comprehensive treatment planning.
Using HSA and FSA Funds for Dental Treatment
Patients with a Health Savings Account (HSA) or Flexible Spending Account (FSA) may be able to use those funds for qualified dental expenses.
These accounts allow eligible healthcare expenses to be paid using pre-tax dollars, which can provide a meaningful financial advantage.
An HSA is generally associated with an eligible high-deductible health plan, and unused funds can remain in the account from year to year. FSAs operate differently and may be subject to annual use and rollover limitations depending on the plan.
Patients considering significant dental treatment should review the rules of their individual HSA or FSA and, when appropriate, consider dental expenses as part of their annual tax and benefits planning.
Paying Directly for Treatment
Some patients prefer to pay for treatment directly rather than finance it.
For smaller procedures, this may be relatively straightforward. For larger treatment plans, however, paying the entire cost at once may unnecessarily reduce savings or liquidity.
A comprehensive treatment plan also does not always need to be completed, or paid for, all at once.
That is one reason financial discussions are especially useful before treatment begins. Understanding the scope and anticipated sequence allows the patient and our team to discuss how payments will correspond with the stages of care.
Interest-Free Payment Plans
Buxmont Prosthodontics & Restorative Dentistry does not use third-party healthcare financing companies such as CareCredit or Cherry.
Instead, in appropriate circumstances, we can work directly with patients to establish payment arrangements at 0% interest.
This avoids adding interest charges to the cost of treatment and keeps the financial arrangement between the patient and the practice.
The specific arrangement depends on the treatment being performed and its anticipated timeline. Our team can discuss the available options with patients before treatment begins so that expectations are clear.
Using Treatment Phasing to Make Complex Care More Manageable
One of the advantages of comprehensive treatment planning is that complex dentistry does not always need to be completed in one continuous series of appointments.
In selected cases, treatment can be phased over a longer period while maintaining a coherent clinical plan.
This is particularly relevant for full-mouth rehabilitation and other extensive restorative cases.
For example, provisional restorations may sometimes be used for an extended period while we evaluate esthetics, function, speech, comfort, and the patient’s adaptation to the proposed changes. Interim restorations can also be useful at certain stages of treatment.
When clinically appropriate, these phases can create natural stopping points in treatment.
That may allow a patient to spread treatment costs over a longer period rather than paying for an entire reconstruction within a short window.
There is an important qualification, however. We do not recommend delaying or sequencing treatment in a way that we believe compromises the result.
Clinical considerations come first.
When there is flexibility in the treatment sequence, however, Dr. Wang and Dr. Chernow can discuss whether the plan can be structured in a way that makes the financial commitment more manageable.
For some patients, thoughtful treatment phasing can make a substantial difference.
The Treatment Plan and Financial Plan Should Work Together
A complex dental treatment plan should answer more than one question.
It should explain what needs to be treated, what the options are, what sequence makes clinical sense, how long treatment is likely to take, and what the financial commitment will be along the way.
At Buxmont Prosthodontics & Restorative Dentistry, we want patients to understand that entire picture before committing to comprehensive treatment.
Depending on the individual situation, the financial plan may involve several components:
- Out-of-network dental benefits
- HSA or FSA funds
- Direct payment
- A 0% interest payment arrangement with our practice
- Clinically appropriate treatment phasing over a longer period
For extensive treatment, the solution is often not finding one financing product. It is developing a clinical and financial plan that makes sense as a whole.
Cost Should Be Part of the Conversation
Complex restorative dentistry represents a meaningful investment, and we do not think patients benefit when that fact is minimized.
We also do not want patients to assume that a comprehensive treatment recommendation automatically means that every procedure must happen immediately or that the entire financial commitment must occur at once.
The first step is understanding the diagnosis and the available treatment options.
From there, Dr. Wang and Dr. Chernow can discuss which parts of treatment are time-sensitive, where alternatives exist, and whether treatment can reasonably be phased without compromising the clinical objective.
Our team can also help patients submit claims for available out-of-network dental benefits and discuss payment arrangements before treatment begins.
At Buxmont Prosthodontics & Restorative Dentistry, our goal is to keep the treatment decision where we believe it belongs: between the patient and the doctor.
Frequently Asked Questions
Does Buxmont Prosthodontics & Restorative Dentistry accept dental insurance?
Buxmont Prosthodontics & Restorative Dentistry is an out-of-network practice and does not participate as an in-network provider with dental insurance companies.
Patients with dental benefits may still have out-of-network coverage. Our team can submit claims on the patient’s behalf so that the patient can receive any reimbursement available under the terms of the individual plan.
Because every plan is different, reimbursement cannot be guaranteed.
Why isn’t Buxmont Prosthodontics & Restorative Dentistry in network with insurance companies?
Our practice is focused on complex restorative and prosthodontic care, where treatment decisions may involve materials, laboratory procedures, implants, esthetics, occlusion, provisionalization, and long term treatment planning.
We believe those decisions should be made through the relationship between the patient and the treating prosthodontist rather than determined by the reimbursement policies of a third-party payer.
We are happy to help patients obtain any out-of-network benefits available to them, but insurance coverage does not determine the treatment Dr. Wang or Dr. Chernow recommends.
Why doesn’t dental insurance cover more of complex dental treatment?
Most dental benefit plans were not designed to function like comprehensive medical insurance for large expenses.
Annual maximums, exclusions, frequency limitations, and procedure-specific reimbursement can mean that a patient requiring multiple restorations, implants, or full-mouth rehabilitation receives benefits covering only a relatively small portion of the total treatment.
This does not necessarily mean the treatment is unnecessary. It may simply fall outside what the patient’s particular dental benefit contract was designed to cover.
Can I receive treatment at Buxmont Prosthodontics & Restorative Dentistry without dental insurance?
Yes.
Dental insurance is not required to become a patient. Many patients receiving complex prosthodontic care pay directly for treatment, use HSA or FSA funds, arrange an interest-free payment plan, or use a combination of these approaches.
Does Buxmont offer payment plans?
For appropriate treatment, Buxmont Prosthodontics & Restorative Dentistry can arrange payment plans directly with patients at 0% interest.
We do not use CareCredit or Cherry. The details of a payment arrangement depend on the treatment plan and anticipated timeline and should be discussed with our team before treatment begins.
Can a full-mouth rehabilitation be spread out over time?
In many cases, there is some flexibility in how complex restorative treatment is sequenced.
Provisional and interim restorations may allow certain stages of treatment to be maintained for a period of time before proceeding to the next phase. This can be useful clinically because it gives the patient and prosthodontist time to evaluate esthetics and function. It may also allow treatment expenses to be distributed over a longer period.
Not every treatment can or should be delayed. Dr. Wang or Dr. Chernow will first determine what sequence is clinically appropriate and can then discuss where reasonable flexibility exists.
Can I use an HSA or FSA for prosthodontic treatment?
Many dental expenses qualify for payment using HSA or FSA funds, although eligibility depends on the expense and the rules governing the patient’s account.
Patients should verify eligibility with their plan administrator or tax professional, particularly when treatment has a significant elective or cosmetic component.
Will you change my treatment plan based on what my insurance covers?
Our treatment recommendations are based on the diagnosis, the patient’s goals, and what Dr. Wang or Dr. Chernow believes is clinically appropriate.
Insurance benefits can certainly be considered when discussing timing and financial planning, but we do not believe a third-party payer should determine which treatment is best for an individual patient.
When clinically reasonable alternatives or flexibility in treatment sequencing exist, we will discuss those options openly so the patient can make an informed decision.