How to Pay for Dental Care Without Dental Insurance in Durham, NC

Most people who call Local Start Dental do not have dental insurance. Some have gone years without seeing a dentist because they assumed the answer would be a number they could not pay. That assumption is the reason a lot of treatable problems turn into extractions.

There is more than one way to pay for dental work in Durham, and they can be combined. This is how it works at Local Start Dental.

Sliding scale fees

Local Start Dental is a nonprofit clinic. Fees are set on a sliding scale rather than a fixed price list, which means qualifying patients pay a reduced rate based on their household income.

Qualifying takes two things: a completed application and proof of household income. The clinic uses that documentation to determine which rate applies. It is worth doing even if you are unsure whether you will qualify, because the application costs nothing but the time it takes to gather your paperwork.

The sliding scale applies to the care you receive at the clinic. It is not a discount card or a membership, and there is no fee to apply.

Payment plans and financing

A reduced rate still has to fit into a monthly budget, especially for larger treatment like dentures or implants. Local Start Dental works with several third-party financing companies so that the cost can be spread out over time:

• Proceed Finance

• CareCredit

• Alpheon Credit

• Healthcare Finance Direct

• Lending Club

• One Main Financial

These are lenders, not the clinic, so approval, interest rates, and repayment terms come from the financing company and vary by applicant. The clinic's team can help you figure out which option makes sense for your situation and walk you through setting it up.

If you are comparing offers, look at the total amount repaid over the life of the plan rather than the monthly payment alone. Two plans with similar monthly figures can differ significantly once interest is included.

NC Medicaid

Local Start Dental accepts NC Medicaid for patients whose coverage includes the appropriate dental benefits.

Adult dental coverage under NC Medicaid is limited and does not extend to every procedure, so what your plan covers depends on your specific benefits. Bring your Medicaid card and information to your first appointment and the front desk can check what applies before treatment is planned. Anything Medicaid does not cover may still be eligible for the sliding scale.

If you have private dental insurance

Local Start Dental does not bill private dental insurance carriers directly. That includes Humana, Blue Cross Blue Shield, Aetna, and similar plans.

That does not mean your insurance is useless here. The clinic provides the records and documentation you need to submit a claim to your insurer yourself for reimbursement. Because you are paying the clinic's sliding scale rate rather than a standard fee schedule, the combination can work out well: you pay a reduced rate up front and then seek reimbursement on top of it.

Check your plan's out-of-network reimbursement terms before your appointment so you know what to expect back.

Implants through a SIDE training course

If the treatment you need is dental implants, there is one more route worth knowing about.

Local Start Dental runs a training division called SIDE, the Southeast Institute for Dental Education, which teaches practicing dentists advanced implant technique. Those courses need patients, and patients who take part receive their implant treatment at a substantially reduced rate.

A few things people usually want to know before they consider it. The dentist placing your implant is a fully licensed, practicing dentist building specialist skills through continuing education, not a student, and every procedure is supervised in real time by an experienced mentor. Treatment happens at the same Durham clinic, and what is included covers the implant procedure, bone grafting if you need it, the permanent crown, post-operative care, and follow-up appointments.

The process starts with a comprehensive exam and diagnostic x-rays at a reduced rate, which is what determines whether you are a candidate and what your treatment plan looks like. Any cleaning or fillings needed beforehand happen at the clinic and fall under the same sliding scale described above. Patient spots in each course are limited.

Learn more about becoming a SIDE patient, or call 919.569.5533 to ask whether you might be a fit.

Combining options

These are not mutually exclusive. A common arrangement looks like Medicaid covering part of a treatment plan, the sliding scale reducing the remainder, and a payment plan spreading what is left across several months.

The only way to know what your particular combination looks like is to come in, complete the income application, and have your treatment needs assessed. Estimates given over the phone before an exam are guesses, and nobody benefits from a guess that turns out to be wrong in either direction.

What to bring to your first visit

• Photo identification

• Proof of household income for everyone in your household who earns

• Your NC Medicaid card, if you have one

• Your private dental insurance information, if you have it

• A list of any medications you take

Starting the conversation

If cost is the reason you have been putting off dental care, the useful next step is a phone call rather than more research. The clinic can tell you what applies to your situation.

Local Start Dental 370 Jackson Street, Durham, NC 27701 919.569.5533

Contact us to schedule an appointment or ask about the sliding scale application.

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This article describes the payment options available at Local Start Dental and is provided for general information. It is not financial, insurance, or clinical advice. Sliding scale eligibility depends on your completed application and documented household income. Financing terms are set by the lender, not by Local Start Dental. Medicaid dental benefits vary by plan and are subject to change under North Carolina Medicaid policy. Participation as a patient in a SIDE training course depends on clinical eligibility determined at your exam and on availability. Contact the clinic to confirm what applies to your situation.