Your employer just told you about a "dental wallet." No insurance card, no explanation of benefits in the mail, no claims to file. Just a card that pays for dental care. If that sounds too simple, that is actually the point. Here is how it works, what is covered, and why it might be the best dental benefit you have ever had.
If you are used to traditional dental insurance, the concept of a dental wallet can feel unfamiliar. With insurance, you pick a dentist from a network, you get a treatment plan, the office submits a claim, the insurer decides what is covered, and weeks later you find out what you owe. A dental wallet skips all of that. It is a fundamentally different approach to paying for dental care, and once you understand it, the old way will feel unnecessarily complicated.
What Is a Dental Wallet?
A dental wallet is an employer-funded account loaded with a set dollar amount for your dental care. Think of it like a prepaid card specifically for dentistry. Your employer decides how much to contribute, that amount loads to your Toothsome dental wallet, and you use it to pay for care at any licensed dentist.
Behind the scenes, your dental wallet is backed by a 213(d) Health Reimbursement Arrangement, or HRA. That is the IRS-recognized structure that allows your employer to set aside funds specifically for healthcare expenses, including dental care. You do not need to understand the tax code to use your wallet. What matters is that it is a real, funded account with real money in it, designated for your dental care.
How to Use Your Dental Wallet: Step by Step
Using your dental wallet is straightforward. Here is exactly what happens from the moment your employer sets it up to the moment you walk out of the dentist's office.
Your employer sets your annual dental benefit
Your company decides the dollar amount to contribute to your dental wallet for the year. This is your benefit, similar to how an employer might set an annual dental insurance budget, except this is real money, not a premium payment to an insurance company.
Funds load to your Toothsome dental wallet
The employer contribution is deposited into your personal dental wallet. You can see your balance anytime in the Toothsome app or online portal. You also receive a Toothsome card, which works like a payment card at any dental office.
You visit any licensed dentist
There are no network restrictions. You can go to the dentist you already see, a specialist your dentist recommends, or a new provider you found on your own. Any licensed dentist in the United States works.
Pay with your Toothsome card at the chair
When the visit is done, you pay the same way you would with any card. The dental office runs your Toothsome card. Eligible expenses are drawn from your wallet balance in real time.
No receipts, no claims, no waiting
That is it. There is no claim to file, no explanation of benefits to decipher, and no weeks-long wait to find out what you owe. You paid at the time of service, and it is done.
What Is Covered?
One of the biggest frustrations with traditional dental insurance is figuring out what is covered and what is not. With a dental wallet, the coverage is simple: any medically necessary dental procedure performed by a licensed dentist.
That includes preventive care like cleanings and exams, diagnostic work like X-rays and evaluations, restorative care like fillings, crowns, and bridges, major procedures like root canals, extractions, and implants, orthodontic treatment, periodontal therapy, and emergency dental care. There is no distinction between "covered" and "not covered" procedures. If it is a legitimate dental service provided by a licensed practitioner, your wallet can pay for it.
What About Rollover?
Here is where dental wallets really differentiate themselves from traditional insurance. With most dental insurance plans, unused benefits disappear at the end of the year. The industry calls this "use it or lose it," and it creates a perverse incentive to either rush into unnecessary treatment in December or waste money you have already paid in premiums.
"Unused dental wallet funds roll over year to year. No use-it-or-lose-it pressure."
With a Toothsome dental wallet, unused funds roll over from year to year, up to $10,000 in accumulated balance. If your employer contributes $1,500 this year and you only use $600, the remaining $900 carries forward. Add next year's contribution and you have $2,400 available. This is especially valuable if you are saving for a larger procedure like orthodontics, implants, or full-mouth rehabilitation. You can accumulate funds over time and use them when you actually need care, not when a calendar deadline forces your hand.
Tax Benefits
Because your dental wallet is structured as a 213(d) HRA, there are tax advantages built in. For your employer, contributions to your dental wallet are tax-deductible as a business expense. They do not count as taxable income for FICA or FUTA purposes either, which means both you and your employer save on payroll taxes compared to a straight salary increase.
For you as an employee, the tax treatment depends on how your employer structures the plan. In many cases, the wallet contributions are not counted as taxable income, meaning you get the full benefit without a tax hit. Your employer or HR team can provide specific details for your company's plan structure.
How It Compares to Dental Insurance
The differences between a dental wallet and traditional dental insurance are substantial. Here is a side-by-side look.
| Feature | Dental Wallet | Dental Insurance |
|---|---|---|
| Provider choice | Any licensed dentist | In-network preferred |
| Annual maximum | Set by employer, with rollover | $1,500 (unchanged since 1973)2 |
| Claims process | None — pay at the chair | Submit claim, wait for EOB |
| Pre-authorization | Not required | Often required for major work |
| Rollover | Yes, up to $10,000 | No — use it or lose it |
| Waiting periods | None | 6-12 months for major work |
| Coverage complexity | Simple — any dental expense | Tiered (preventive, basic, major) |
The $1,500 annual maximum on traditional dental insurance has not changed since 1973.2 Adjusted for inflation, that would be over $11,000 today. Meanwhile, a single dental crown costs between $750 and $2,000.3 One procedure can consume your entire annual benefit. A dental wallet gives you real purchasing power that accumulates over time, instead of a fixed cap that has lost most of its value over five decades.
Why This Matters
Nearly half of all Americans skip dental care because of cost.1 Even people who have dental insurance avoid the dentist because of copays, coverage gaps, and the complexity of figuring out what their plan actually covers. When dental care is deferred, small problems become big problems. A cavity that costs $200 to fill becomes a root canal and crown that costs $2,500. A manageable case of gum disease becomes advanced periodontitis that affects your heart, your diabetes management, and your overall health.
A dental wallet removes the barriers that prevent people from getting care. No network restrictions means you do not have to switch dentists. No claims means no paperwork. No use-it-or-lose-it means no pressure to rush decisions. You just go to the dentist, get the care you need, and pay with your card.
Frequently Asked Questions
If you have additional questions about your dental wallet, visit our employee FAQ page or reach out to your HR team. Your dental wallet is designed to make dental care simple, accessible, and affordable. The hardest part is booking the appointment.