Seeing the Dentist Without Insurance in Roanoke: Your Real Options

Three ways people pay here without insurance

If you don't have dental insurance, you're in ordinary company at this practice. Plenty of our patients are self-employed, retired early, working somewhere that doesn't offer a dental plan, or between jobs. Not having a plan doesn't change whether you can be seen. It changes how you pay, and how much arithmetic you want to do before you sit down.

There are three ways to handle it, and most people use more than one of them over the years.

• Pay as you go. You pay our standard fee for what you need, when you need it. For someone who comes in for routine visits and rarely needs anything else, this can be the right answer, and it takes no planning at all.
• Join the Virginia Dental Club. An annual membership built for patients without dental insurance. It changes what your routine visits cost and what most other treatment costs.
• Finance a larger treatment plan. For work that runs across several appointments, a third-party health care financing card such as CareCredit spreads the bill over months instead of asking for it all at once.

What the Virginia Dental Club actually is

It's a membership plan administered by Membersy LLC, not insurance. There's nothing to file, no waiting period, and no annual maximum. Acceptance is guaranteed, membership starts right away, and you pay the office directly at the time of service.

Your membership includes two cleanings, two routine exams, one problem-focused emergency exam, and your X-rays at no charge each membership year. Most other services are discounted off our standard fee, including fillings, crowns, root canals, dentures, implants and periodontal treatment.

It isn't a discount on everything, and we'd rather you hear that now than at the front desk. Orthodontics including Invisalign, whitening and other elective cosmetic work are not part of the membership discount. Fluoride and sealants are discounted rather than included. Membership also can't be combined with dental insurance or with any other office promotion. The current price, and the full list of what is and isn't part of it, live on the Virginia Dental Club page.

The math to run before you join

Here's the arithmetic, in the order we'd do it ourselves. It takes one phone call and a few minutes with a pencil.

• Ask for two numbers. What the membership costs for a year, and what a routine visit costs at our standard fee without it: the exam, the X-rays and the cleaning. The front desk at either office can give you both before you book.
• Price a full year, not one visit.The membership is built around two routine visits a year, so price two. If it's been several years since your last visit, your first appointment may call for a deeper cleaning, and periodontal treatment is discounted rather than included.
• Compare the two. If a year of routine care at the standard fee lands at or near the membership price, the membership has roughly paid for itself before anything else happens, and the discount on most other treatment that year comes on top of that.
• Add your household. Additional members in the same household join at a lower rate than the first, so a couple or a family moves the math further in the same direction.
• Price the thing you already know about.If you've been putting off a filling or a crown, ask what it runs at member pricing before you decide. That one number often settles it.

One caution worth repeating: don't join expecting a break on Invisalign or whitening. If that's what you came for, membership isn't the tool.

How CareCredit works, in plain terms

CareCredit is a third-party health care financing card. It isn't ours, and it isn't a discount. You apply, and if you're approved you have a credit line you can use for dental care. The office is paid at the time of service, and you repay the card company over time.

Two honest cautions. It's a credit account, so what you're offered depends on your application and on the repayment plan you choose, and those terms belong to the card company, not to us. Read the agreement before you sign it, and ask what happens if the balance isn't paid off on the schedule you agreed to. Financing spreads a bill out, it doesn't shrink it, which is why it makes more sense for a longer treatment plan than for a cleaning.

The front desk can walk you through the application before treatment starts. Other ways to pay, including major credit cards and FSA and HSA cards, are listed on our payments page.

What actually drives the number

When someone asks what a tooth will cost, the answer almost always turns on four things.

• How far the problem has gone. A small cavity is a filling. The same cavity left another year can become a crown, and if it reaches the nerve, a root canal and a crown. Waiting is usually what turns a small bill into a large one.
• How many teeth are involved.One tooth is one conversation. Six teeth is a sequence, and a sequence can often be phased over months if that's what makes it possible.
• Whether something has to be custom made.Crowns, dentures and implant restorations are made to fit your mouth and no one else's. That work is part of the fee, and it's a real reason those numbers run larger than a filling.
• How many visits it takes. Some repairs take one appointment. Others are a series with healing time in between, and the cost arrives in pieces rather than all at once.

It's also why no one can give you an accurate number over the phone for a tooth they haven't seen. We can tell you what an exam, X-rays and a cleaning cost. Past that, we need to look. Regular preventative careis how problems get caught while they're still at the small end of that list.

Why we quote before we start

Before any treatment beyond a standard cleaning, you get a written estimate showing your portion, including any membership discount. You can take it home. You can sleep on it. You can ask another dentist what they'd do. No surprise bills is the rule here, not a slogan.

Five questions worth asking about any estimate you're handed:

• What happens if I wait?Sometimes the honest answer is that watching it for six months is reasonable. Sometimes it's that this gets harder and costlier the longer it sits. Ask, because we'll tell you either way.
• What's the smallest step that solves this today? There's often something that stops the pain or protects the tooth now and buys time for the rest.
• Can this be phased? Most plans that involve several teeth can be put in order of urgency and spread out.
• What isn't in this number? Ask whether the estimate includes the follow-up visit, the crown after a root canal, or anything else that usually comes next.
• What if you find more once you start? Now and then a tooth needs more than the X-ray suggested. Ask how that would be handled before you begin, so nothing about it comes as a surprise.

Where to start this week

If you're not certain whether you have a plan at all, maybe through a spouse or a job you started this year, call before you assume you don't. Our front desk checks plans all day, and our insurance page lists the ones we work with most often.

If you know you have nothing, call and ask for the two numbers above. The Electric Rd office, where Dr. David Perry practices, is 540-774-8288. The Brambleton Ave office, where Dr. Razi practices, is 540-774-3143. Both are in Cave Spring, and both see patients Monday to Friday, 8:00 AM to 5:00 PM. If calling during the workday is the hard part, scheduling is open around the clock, so you can book online tonight. Either way, the written estimate still comes before any treatment beyond your cleaning.