No Insurance? Out-of-Network Insurance?

Dental Membership Plan

Cristen D. Whitmer DDS is pleased to offer our patients the option of enrolling in our in-house dental membership plan to help cover the costs of their dental treatment. These membership plans are great for those who do not have dental insurance or those who have an insurance that is out-of-network. Many insurance providers make it seem like you do not have a choice in what treatments you can receive, which can sometimes prevent you from getting the proper care. As a great alternative, we offer 4 convenient membership plans for your dental care needs!

Membership Benefits:

  • No Annual Maximums
  • No Pre-Authorizations
  • No Waiting Periods for Fillings/Crowns
  • No Limitations for Pre-existing Conditions
  • No Missing Tooth Clause (insurance won’t pay for an implant)
  • No Claim Forms
  • No Insurance Cards
  • No Frequency Limitations
  • 20% off All Dental Services
  • Benefits Begin the Day You Sign Up!

*Rules & Regulations apply. Please see a team member for more information.

Yearly Plans We Offer

Plan A: New Patient- ADULT (13 & up)
Annual Fee: $554 per individual* (as compared to $693 out of pocket, savings of $139)
  • 1 New Patient Exam
  • 1 Check-up Exam
  • 1 Emergency Exam (use anytime of the year)
  • 2 Regular Cleanings (prophy or perio maintenance only)
  • 2 Oral Cancer Screenings
  • 2 Fluoride Treatments
  • 1 Set of Full Mouth X-rays
  • Any additional X-rays needed throughout the year
  • 20 % off of all other dental services, ie: scaling/root planning, Invisalign, fillings, core buildups, extractions, crowns, dentures, partials and implants. Does not include cosmetic services.
Plan B: New Patient – CHILD (under 13)
Annual Fee: $482 per individual* (as compared to $603 out of pocket, savings of $121)
  • 1 New Patient Exam
  • 1 Check-up Exam
  • 1 Emergency Exam (use anytime of the year)
  • 2 Regular Cleanings (prophy or perio maintenance only)
  • 2 Oral Cancer Screenings
  • 2 Fluoride Treatments
  • 1 Set of New Patient X-rays
  • Any additional X-rays needed throughout the year
  • 20% off of all other dental services, ie: dental sealants, fillings. Does not include cosmetic services.

Plan C: Existing Patient – ADULT (13 & up)
Annual Fee: $506 per individual* (as compared to $633 – out of pocket cost savings of $127)
  • 2 Check-up Exams
  • 1 Emergency Exam (use anytime of the year)
  • 2 Regular Cleanings (prophy or perio maintenance only)
  • 2 Oral Cancer Screenings
  • 2 Fluoride Treatments
  • 1 Set of Check-up X-rays
  • Any additional X-rays needed throughout the year
  • 20 % off of all other dental services, ie: scaling/root planning, Invisalign, fillings, core buildups, extractions, crowns, dentures, partials and implants. Does not include cosmetic services.
Plan D: Existing Patient – CHILD (under 13)
Annual Fee: $400 per individual* (as compared to $500 out of pocket cost, savings of $100)
  • 2 Check-up Exams
  • 1 Emergency Exam (use anytime of the year)
  • 2 Regular Cleanings (prophy or perio maintenance only)
  • 2 Oral Cancer Screenings
  • 2 Fluoride Treatments
  • 1 Set of Check-up X-rays
  • Any additional X-rays needed throughout the year
  • 20% off of all other dental services, ie: dental sealants, fillings. Does not include cosmetic services.

 

How does a Membership Plan work with an Out-of-Network Insurance policy?

Since your insurance is out-of-network, your dental fees are the Usual and Customary Rate (UCR) that Dr. Whitmer charges for her services. Dr. Whitmer will accept your insurance, and even submit claims on your behalf, but because she is not a contracted provider, you will only have partial reimbursement for your dental care. With a Membership Plan, you can be assured that all your routine dental care* will be covered at 100% and you receive a discount on all other services. See example below.

**This is for example purposes only:

WITHOUT MEMBERSHIP PLAN:

Cleaning (UCR) $130 > Insurance pays $ 62 > Patient’s responsibility $ 68
Filling (UCR) $300 > Insurance pays $108 > Patient’s responsibility $192

WITH MEMBERSHIP PLAN:

Cleaning (UCR) $130 > Insurance pays $62 > Patient’s responsibility $ 0
Filling (UCR 20% off) $240 > Insurance pays $108 > Patient’s responsibility $132
SAVINGS OF $ 128!!!

In other words, your out-of-network insurance plan acts as an additional funds source for you to help pay for your dental treatment.

*Routine dental care includes 2 periodic exams, 2 cleanings prophy or perio maintenance, 2 fluoride treatments, all X-rays, 2 oral cancer screenings.