INSURANCE
At Toothology Dental, we work with most PPO insurance plans and our team is here to help you understand your benefits, maximize your coverage, and make sense of what your plan actually covers — before treatment ever begins. We believe cost should never be a barrier to a healthy smile, and we’re committed to making your care as accessible as possible.
Transparent pricing. Flexible options. No surprises.
Understanding Your Insurance Options
Toothology Dental accepts most PPO dental insurance plans. We work directly with your insurance provider to help maximize your benefits and minimize your out-of-pocket costs. Not sure what your plan covers? Our team is happy to review your benefits before your appointment so you know exactly what to expect — no guesswork, no surprises.
It’s important to understand the difference between in-network and out-of-network coverage. In-network providers have agreed to set fee schedules with your insurance company, which can reduce your costs. Out-of-network providers may still be covered by your plan, often at a slightly different reimbursement rate. Either way, our team will help you understand your benefits and make the most of your coverage.
For patients who prefer a fee-for-service model or whose insurance doesn’t cover certain procedures, we offer clear, upfront pricing and multiple payment solutions to ensure you can move forward with the care you need. Ask us about our in-house membership plan — a simple, affordable option for patients without traditional dental insurance.
What Does My Insurance Actually Pay For?
Most PPO dental insurance plans organize coverage into three tiers. Preventive care — routine cleanings, exams, and X-rays — is typically covered at or near 100%, because catching problems early costs far less than treating them later. Basic procedures like fillings and simple extractions are usually covered around 80%, while major procedures such as crowns, bridges, and root canals tend to fall closer to 50% and may be subject to waiting periods depending on your plan. Cosmetic treatments are generally not covered at all.
Most plans also carry an annual maximum — a cap on what your insurance will pay out per year, typically between $1,000 and $2,000. Once that limit is reached, remaining costs become your responsibility until your plan resets. For anything not covered, Toothology Dental offers flexible financing through CareCredit, Cherry, and Alfion, along with an in-house membership plan designed for patients without insurance. Our team is always happy to help you review your benefits and plan your care accordingly.
What to Bring to Your First Appointment
Getting a few things together before your first visit helps our team verify your coverage quickly, keeps your appointment running on time, and ensures there are no surprises at checkout. Here’s what to bring:
- Your insurance card: This gives our team the information needed to verify your benefits and confirm your coverage before treatment begins. If you have both a primary and secondary insurance plan, bring both cards.
- A valid photo ID: A driver’s license or government-issued ID is required for check-in and helps us keep your records accurate.
- Your new patient forms: To save time in the office, we encourage new patients to complete their patient forms online before their appointment. If you weren’t able to complete them ahead of time, plan to arrive a few minutes early.
- A list of current medications: Include any prescriptions, supplements, or over-the-counter medications you take regularly. This helps Dr. Gorgan provide care that’s safe and informed by your full health picture.
- Any relevant dental records or X-rays: If you’ve had recent X-rays taken at a previous practice, bringing those along — or having them transferred ahead of time — can reduce the need for duplicate imaging on your first visit.
If you have any questions about your coverage or want to verify your benefits before your appointment, don’t hesitate to contact our office ahead of time — we’re happy to help.
FREQUENTLY ASKED QUESTIONS
What insurance plans does Toothology Dental accept?
We accept most PPO dental insurance plans. Specific carrier participation may vary, so we recommend calling our office before your visit and our team will be happy to verify your benefits and answer any coverage questions.
What if I don't have dental insurance?
No insurance? No problem. We offer flexible financing through CareCredit, Cherry, and Alfion, as well as an in-house membership plan designed to make routine and preventive care affordable without traditional insurance. Our team can help you find the option that makes the most sense for your situation.
What's the difference between in-network and out-of-network?
In-network providers have a contracted fee schedule with your insurance company, which typically means lower out-of-pocket costs for you. Out-of-network providers haven’t entered into that agreement, so reimbursement rates may differ. We recommend calling our office to discuss your specific plan so we can give you a clear picture of your coverage before treatment begins.
