Goodbye Dental Insurance!
LAT Dentistry strives to provide the highest level of comprehensive dental care available. We are also acutely aware and extremely sensitive to the financial strain that dental care can put on a family's finances, along with the difficulties that come with dental insurance plans.
We are proud to introduce our SMILE CLUB- a simple affordable, & transparent dental savings membership.
(Official membership details coming soon… subscribe for updates below!)
We’ve cut out the insurance middle-man and instead, we’ve created a membership with a large emphasis on regular care to protect and preserve your family’s health while simultaneously keeping costs down. No waiting period. No hidden fees. No hassle. With The Smile Club, you can avoid the sticky red tape of confusing insurance policies. Since we have cut out the middle-man in your care (the insurance company), we don’t have to staff extra team members to process claims or hassle with insurance all day… which means more savings we can pass along to you. Thanks to our Smile Club, we can offer fees that are reasonable and transparent, and we can focus our attention on the quality of care you receive. We aim to see lower volumes of patients and spend more time with you to play an important role in your healthcare and wellness. Need more convincing on why you should say goodbye to traditional insurance? We’re here to enlighten you on the in’s and out’s of why our Smile Club is the right choice over your standard insurance policy.
Freedom to choose your care- Many insurance plans strongly encourage you to choose from a limited list of in-network providers because that is how they save the most money. Although seeing a dentist that is in-network with your insurance may save you a few dollars at the moment, the savings of our Smile Club can far outweigh the savings from seeing an in-network dentist while guaranteeing the highest quality of care.
Providing affordable access to maximum savings- Most insurance policies average’s around $450-500/year, per family member. Our Smile Plan is only $1/day per adult, even less for children, includes more preventative yearly maintenance than most plans, and still offers a 10% discount on all additional treatment. It’s as simple as that.
No yearly maximum. No deductibles.
Typically insurance plans will pay a max of about $1500/year, which covers a crown OR several fillings, but not much more than that. With your Smile Club membership, you can expect to avoid any maximums, hidden fees, or deductibles.
No denials- We care about your health and believe no one should be turned away because of pre-existing conditions. Unlike many traditional insurance policies, we do not require a medical exam to qualify for our membership. No pre-authorizations. No waiting periods. Our enrollment process is simple and becomes active the day you sign up.
Understanding Dental Insurance Restrictions
There are many stipulations and clauses that come along with a standard dental insurance policy- usually resulting in the cons outweighing the pros. We have seen the struggles and frustrations this can cause firsthand and understand that this can become misleading if you miss something within the fine print of the contract prior to signing up. With our Smile Plan, our pricing is clear, so you don’t have to filter through all of the clauses in order to have your dental needs cared for. Below, we have broken down some of the restrictions and clauses that are likely implemented in your insurance plan:
Least Expensive Alternative Treatment: A dental plan may not allow benefits for all treatment options. A least expensive alternative treatment (LEAT) provision is a limitation found in many plans that reduces benefits to the least expensive of other possible treatment options as determined by the benefit plan design, even though the dentist and patient have agreed that a particular treatment is in the patient’s best interest. Generally, when a dentist signs a participating provider agreement (i.e., contract), they agree to abide by the dental plan’s processing policies which are used to control costs. These policies are typically not found in the agreement itself but can be found in the dentist’s provider’s manual or in the payer’s online portal.¹
Example: If you want to replace teeth with a bridge or with an implant, the insurance company will only pay if you are having a Removable Partial Denture made since that is the cheapest way to replace the missing teeth.
Missing Tooth Clause: When people purchase an insurance policy, it has a date when it goes into effect. Insurance policies that include a missing tooth clause will not cover dental restorations if the tooth was missing before the policy went into effect. The missing tooth clause can also include a waiting period. When that is the case, the policy will not cover a tooth replacement if the tooth was lost during this waiting period. Waiting periods differ from one insurance company to the next. However, waiting periods can be as long as five years.²
Example: If someone loses a tooth on June 1 and the insurance policy goes into effect on June 2, the policy will not cover the restoration.
Non-Duplication Clause: Some dental plans have a “non-duplication of benefits” clause which applies when you have more than one dental insurance plan. This means your secondary health plan will not pay any benefits if the primary plan paid the same amount or more than what the secondary plan allows for the same procedure and dentist.³
Risk-Based Plan: The level of care you are allowed to receive is based on your risk as determined by the insurance company. Your insurance company may only pay for 1 cleaning or X-rays once every year or once every 2 years if you are considered low risk. Any additional work done at that time comes out of the patient’s pocket.
Age Restrictions: Many insurance companies have age restrictions for treatments such as fluoride treatment or orthodontics/Invisalign treatment. Often, they decline any coverage for treatment such as fluoride or Invisalign after age 18, leaving the patient responsible to cover the entire bill. We do not believe these services should be limited to only children.
*The Smile Club is a dental savings plan and is NOT dental insurance/cannot be combined with dental insurance. This membership will only be honored at LAT Dentistry by Dr. Lindsay Thorn. Memberships may be purchased immediately but are not effective until LAT Dentistry’s opening date in February 2022.
¹ada.org / ²familychoicedentistry.org / ³guadriandirect.org