Employee FAQ

You'll receive an email invitation to create your Toothsome account. Once logged in, you can see your balance, transaction history, and use the wallet to pay for dental care. You can access your account via web or mobile app.

Your employer sets your allocation — typically a monthly or annual amount. Log in to your Toothsome account to see your current balance. The amount may vary based on your coverage tier (individual, employee + spouse, family).

Yes! There are no network restrictions. You can visit any licensed dentist in the United States. If you visit a Toothsome network provider, you'll benefit from pre-negotiated fair market rates (70th percentile for your region), which can lower your out-of-pocket costs.

You can use your wallet for any dental care — from routine cleanings and exams to crowns, implants, orthodontics, and oral surgery. Medically necessary procedures (IRS Section 213(d) eligible) are tax-advantaged through your employer's HRA. Your employer may also fund cosmetic options, though those have different tax treatment. Check your plan details for specifics.

You pay your dentist directly at the visit, just like you would normally. After your appointment, submit the itemized receipt through the Toothsome app. We verify that the procedures are eligible, and you're reimbursed via payroll. Payments are processed within days, not months.

Your wallet covers as much as it can, and you pay the difference out of pocket. For example, if you have $500 in your wallet and a procedure costs $800, your wallet pays $500 and you pay $300 directly to the dentist.

No. There's no pre-authorization requirement for any procedure. If your dentist recommends it and you want to proceed, you can. No waiting for approval, no surprise denials after the fact.

Unlike traditional insurance, unused funds can roll over based on your employer's plan. If your employer has enabled rollover, unspent funds accumulate for future dental needs — no "use-it-or-lose-it" pressure. Check with your HR department for your specific rollover policy.

There's no arbitrary cap on how much dental care you can receive. Your "maximum" is simply your wallet balance. As your employer adds funds and your balance grows, you can use it all when you need it — even for bigger procedures like implants.

Your employer's policy determines what happens to unused funds. Some employers allow you to keep a portion of accumulated funds, while others retain them. Check with your HR department for your specific plan details.

Toothsome is structured as an HRA (Health Reimbursement Arrangement). Reimbursements for medically necessary dental procedures (IRS Section 213(d) eligible) are pre-tax — meaning you get 30-35% more purchasing power compared to paying out of pocket. Cosmetic procedures that don't qualify under 213(d) may have different tax treatment.

Unlike FSAs, your Toothsome funds can roll over based on your employer's plan — no use-it-or-lose-it. Unlike HSAs, your wallet is dedicated to dental care and doesn't require a high-deductible health plan. Your employer funds the wallet, and you use it at any dentist — we handle the administration.

Yes, if your employer offers family coverage. You can add dependents to your Toothsome account and they'll have access to the shared wallet balance. Family allocations are typically higher to account for multiple people.

Typically, your family shares one wallet balance. This gives you flexibility — if one family member needs significant dental work, you can use more of the balance for them. You can see each family member's usage in your account.