What is an In-House Dental Plan?

In-house dental plans, also known as dental membership plans, are offered directly by your dental practice to your patients. Patients subscribe by making monthly or annual payments, which grant them access to preventive care like exams, X-rays, and cleanings, along with potential discounts on other services.

This simpler, all-in-one arrangement replaces traditional insurance hassles like waiting periods and filing claims.

Unlike insurance that involves a third-party provider, in-house dental plans establish a direct relationship between your practice and your patients. This means that care decisions are made collaboratively without interference from insurance companies. For patients who have had negative experiences with insurance denials or limitations, offering an in-house dental plan can provide a refreshing alternative.

These plans are particularly beneficial for individuals and families without dental insurance, freelancers, or small business owners who cannot afford group dental benefits.

Structure and Services of In-House Dental Plans

In-house plans emphasize preventive treatments. Cleanings, exams, and routine X-rays are typically included in the base fee, while restorative procedures like fillings and crowns and cosmetic treatments such as whitening and veneers are offered at reduced costs. There's no need for pre-approvals, and coverage begins immediately.

In addition to preventive services, some in-house dental plans may offer additional perks such as emergency examinations or priority scheduling. For instance, if a patient experiences a sudden toothache or dental injury, being a member might guarantee them same-day appointments or extended office hours.

Many plans provide flexibility in customizing the level of services. Some practices offer tiered membership levels, where higher tiers include more comprehensive services like periodontal maintenance or orthodontic consultations. This customization allows you to offer plans that best fit your patients' oral health needs and financial situations.

Payment Options: Monthly vs. Annual

• Monthly Payments: Offering a smaller amount each month can be easier on your patients' budgets upfront. It spreads out the cost and makes dental care more accessible for those who may not have the means to pay a lump sum. However, some practices might include administrative fees, so over a year, the total cost of the in-house dental plan could be higher than the annual option. It's important to carefully calculate the total annual expenditure when choosing this option for your practice.

• Annual Payments: A one-time fee often comes with a slight discount. If patients prefer a single payment and want to avoid monthly charges, this is a straightforward choice for your in-house dental plan. Paying annually can also save them money in the long run and simplifies budgeting.

In both cases, you eliminate the complexities of filing claims and waiting for approvals, establishing a direct relationship with your patients. Some practices also offer family plans, which bundle services for multiple family members at a discounted rate.

What are the Benefits of In-House Dental Plans?

Benefits for Patients

In house dental plans are often more affordable than traditional insurance. A fixed fee covers standard preventive care and provides discounts on treatments without the usual caps or excessive paperwork.

Simplicity is another major advantage. Patients deal directly with your practice, so there's no confusion about provider networks or third-party approvals. There's no need to worry about out-of-network charges, deductibles, or denied claims. This clarity encourages people to maintain their oral health—with no waiting periods or surprise bills.

Once enrolled in an in-house dental plan, coverage typically begins immediately, and optional monthly payment plans help patients budget comfortably. Additionally, patients often receive personalized care and build stronger relationships with their dental providers.

Preventive care included in the plan helps detect issues early, potentially saving patients from costly treatments down the line. Regular check-ups, cleanings, and X-rays can prevent minor problems from escalating into major dental concerns.

For those with pre-existing conditions, in-house dental plans do not impose exclusions or waiting periods that are common with traditional insurance. This means your patients can receive the care they need right away without delays or additional paperwork.

Benefits for Dental Practices

Predictable monthly or annual payments from in-house dental plans provide steady revenue throughout the year—no more waiting on insurance reimbursements. A consistent flow of funds makes financial forecasting clearer and encourages patients to schedule regular visits.

You gain more face time with your patients. Without maximum annual limits, you'll see patients return for ongoing care instead of skipping visits. The direct nature of these plans reduces administrative overhead since there's less need to chase after claims or clarify insurance codes.

Offering an in-house dental plan sets your practice apart from competitors, attracting new patients who are uninsured or dissatisfied with their current insurance.

By eliminating the middleman, you can offer services at reduced rates and still maintain profitability. This can lead to increased case acceptance rates, as patients are more inclined to proceed with recommended treatments when they are more affordable.

Additionally, the data collected from membership plans can provide valuable insights into patient behaviors and preferences, so you can tailor your services and marketing strategies.

What are the Drawbacks of In-House Dental Plans?

Drawbacks for Patients

An in-house dental plan is tied to the specific practice offering it. If your patient needs a specialized procedure you don't provide—or if they move—they can't transfer their membership privileges to another provider.

There are also annual spending limits for certain procedures. Once patients reach these limits, additional treatments might not receive any discounts. Orthodontic care or major reconstruction can have separate limits or exclusions. And unlike traditional insurance, these plans aren't portable if patients switch providers.

Furthermore, in-house dental plans typically do not cover services outside your dental practice, such as specialist referrals. If patients require complex procedures that you don't offer, they'll need to seek care elsewhere without the benefit of discounts or coverage.

Another consideration is that while preventive care is included, the cost for extensive restorative or cosmetic procedures, even at a discounted rate, can still be significant. Patients need to evaluate whether the plan adequately meets their potential dental needs.

Since these plans are not regulated like insurance products, there may be variations in terms and conditions, which could lead to misunderstandings about what is covered. Make sure to thoroughly communicate the plan details and for patients to ask questions before enrolling.

Drawbacks for Dental Practices

Managing patient membership records and payments requires daily oversight. Without dedicated staff or a reliable system, the additional administrative load of an in house dental plan can become overwhelming.

Pricing memberships incorrectly is another risk. The plan needs to be attractive compared to typical insurance but still remain profitable. This requires careful planning and understanding of local competition. You also need to allocate enough budget for marketing, or patients might overlook the option altogether.

There is potential financial risk if patients use a high volume of services that exceed the costs covered by their membership fees. You must balance offering value to patients while ensuring that the plan is financially sustainable.

Implementing an in-house dental plan may also require changes to existing workflows and staff responsibilities. Training staff to manage memberships, explain benefits, and handle billing can be time-consuming and may require additional resources like automation.

Finally, you must be cautious to comply with legal and regulatory requirements related to healthcare memberships, so that the plan doesn't inadvertently violate insurance laws or regulations.

Who Should Consider an In-House Dental Plan?

Certain practices can benefit the most from in house dental plans.

• Smaller offices can use these plans to generate regular cash flow without dealing with third-party reimbursements.

• In areas where many patients lack insurance, offering an in-house dental plan membership option is valuable. If your community struggles with the cost of care, a transparent fee structure can encourage people to visit your practice more often.

• Practices specializing in cosmetic dentistry often favor in-house dental plans since traditional insurance rarely covers elective work. Creating a plan that includes whitening or veneers builds an attractive package that sets your practice apart.

• Newer offices aiming for quick growth and a strong reputation can benefit from these plans too. Promoting an in-house dental plan to kickstart patient enrollment helps create a loyal base.

How to Implement an In House Dental Plan Successfully

1. Design Your In-House Dental Plan

Begin by considering the bottom line. Many offices target an annual fee between $275 and $350 for preventive services, then offer members a 10–15% discount on other treatments. Setting a fair price requires understanding your local market and patient demographics, and deciding which services to include or exclude in your in house dental plan.

Consider offering different levels of membership to cater to various patient needs. For example, a basic plan might include two cleanings per year, while a premium plan includes additional services like fluoride treatments or emergency exams. Clearly outline the benefits of each tier to help patients choose the best option for their needs.

Be transparent and provide detailed information about what is covered, any limitations, and the cost of additional services. 

2. Training and Educating Your Team

Your front desk staff and hygienists should understand the details of the in-house dental plan. Hold training sessions to familiarize all team members with the plan's features, benefits, and enrollment process. Equip your staff with resources like brochures or FAQs to assist them in answering patient questions effectively.

Encourage your team to discuss the plan proactively with patients, highlighting how it can meet their specific needs. Role-playing scenarios can help staff feel more comfortable discussing the plan and handling objections.

3. Promoting Your In-House Dental Plan

Display the plan details prominently on your website. Use flyers, handouts, and social media to inform current and potential patients about the in house dental plan membership. Encourage satisfied members to spread the word—their recommendations often carry more weight than any digital campaign.

Consider offering introductory promotions or incentives for early sign-ups. Hosting informational sessions or webinars can also educate the community about the benefits of your plan.

Collaborate with local businesses or community organizations to reach a broader audience. For example, partnering with local gyms or wellness centers can attract health-conscious individuals who value preventative care.

Strategic Pricing and Financial Considerations

Your pricing needs to be sustainable over the long run. To do so, some practices charge an enrollment fee to cover administrative tasks.

Analyze your practice's overhead costs, the average number of services provided per patient, and the desired profit margins. Use this data to set membership fees that cover costs while remaining competitive.

Consider consulting with a financial advisor or accountant who specializes in dental practices to help with pricing strategies and financial projections.

Implementing cancellation or refund policies can also protect your practice financially if patients decide to discontinue the plan prematurely.

Support Your Dental Plan with Staffing Solutions

Offering an in house dental plan means fewer out-of-pocket surprises for your patients and a steady income stream for your practice. When people know what they'll pay, they're more likely to keep up with routine visits or necessary treatments.

The real strength of in-house dental plans comes from having the right people in place. A knowledgeable and friendly staff adds personal touches that keep patients returning. Dental staffing platforms like Teero support your practice by ensuring you always have a dental hygienist on call to see your patients. Give us a call to learn more.