Membership Plans Are Replacing PPOs. Here's How to Set One Up.

A dental membership plan is simple: patients pay you directly - usually $25-$45/month - and they get preventive care plus discounts on everything else. No insurance company in the middle. No write-offs. No denied claims.

It's not a new idea. But it's having a moment, and for good reason.

Why Membership Plans Work

Recurring revenue. 200 members at $35/month = $84,000/year in predictable income that hits your account whether patients show up or not. That's cash flow stability most practices dream about.

No write-offs. A PPO patient's crown generates $660 after a 45% write-off. A membership patient pays $960 (20% member discount on your $1,200 fee). That's $300 more per crown, and you don't wait 45 days for the check.

Better patient loyalty. Membership patients show up. They have skin in the game - they're paying monthly and they want to use what they're paying for. Retention rates run 80%+ compared to 60-70% for PPO patients.

No middleman. No pre-authorizations. No downcoding. No claim denials. No EOB confusion. You set the fee schedule. You control the experience.

Typical Pricing

Most successful plans land between $25-$45/month for adults. Here's what a typical plan includes:

• 2 cleanings per year (or 3-4 perio maintenance visits for perio patients)
• 2 exams per year
• Necessary x-rays (1 set of BWX, 1 pano per year)
• 15-20% off all other treatment
• No deductibles, no waiting periods, no annual maximums

At $35/month, a patient pays $420/year for preventive care. Compare that to dental insurance: the average individual dental insurance premium is $360-$600/year, with a $50-$100 deductible, a $1,000-$1,500 annual max, and coverage that still leaves patients paying 20-50% of major procedures.

Your membership plan is genuinely a better deal for most patients. And it's a dramatically better deal for you.

Sources: BoomCloud industry data, ADA membership plan surveys, Dental Economics