Your members' most expensive claims begin as a disease nobody feels.
More than four in ten insured adults have gum disease. Most have no idea — it stays silent until it becomes the crown, the root canal, the implant. This is the preventive program built for the members who will never floss, at no cost to your plan.
Nobody files a claim for the disease. They file it for what the disease became.
You already know the shape of it. A member's gum disease starts quietly. No pain, no warning, nothing that sends them to a chair. So it goes untreated — and untreated is the only direction it travels.
By the time it surfaces, it has changed addresses. It is a crown now. A root canal and a crown. An implant.
A single crown runs $1,000 to $1,800. A root canal with the crown, often $1,500 to $3,000. An implant, $3,000 to $6,000. (ADA Health Policy Institute; market ranges, 2024–25.) Every one of them lands on your claims sheet — the predictable, expensive back end of a disease that was cheap and silent at the front.
Nobody files a claim for the disease. They file it for what the disease became.
The problem was never information. It was adoption.
The standard answer is to tell people to floss more. Carriers have printed that sentence on member materials for thirty years. Look at the result.
About one in three adults floss daily, by the CDC's own national survey — and because that number is self-reported, the real figure is almost certainly lower. (CDC NHANES; Fleming et al., 2018.) It has barely moved in over a decade.
Members already know they should floss. The gap is which tool a person will actually pick up and use. That is the lane no benefit has seriously addressed — not because it doesn't matter, but because it is harder than printing a reminder.
The problem was never which tool wins in a lab. It is which tool a member will actually use.
Fund prevention. Reduce gum disease. Bend the medical-cost curve.
Here is the chain at the altitude it can actually defend — because your medical director will check every link.
Your competitors already fund prevention. The lane still open is the member who never flosses.
This is not a theory you would be piloting. Your peers did the math on their own books and decided it was worth funding.
What none of them has solved is the front of the funnel — the one-in-three members who will never floss. That is the uncontested lane.
Care Beyond The Chair®
A clinical-grade sonic toothbrush, and a water flosser. Bought at retail, the pair runs more than $200. Your members will never pay that — because this price exists only through your program.
That ten-dollar step is the entire design. It is how a water flosser ends up in the hands of a member who would never have bought one on their own — the easier tool, in the hand of the person least likely to floss. That is where prevention actually starts.
And it costs your plan nothing. Members pay the discounted price. You provide the access, and you reap the downstream of healthier members. A genuine win on both sides of the table.
A program is only worth funding if it arrives.
You are not betting on a startup's first launch. You are plugging a proven fulfillment engine into a gap in your benefit.
Standard fulfillment turns around in days. Co-branding — your plan's name on the device — is available at $0.80 per unit above a 1,000-unit run. The infrastructure is already built.
Fair questions. Straight answers.
You're already paying for the disease. Start paying for the prevention.
Your members' gum disease is already on your book, already converting quietly into the most expensive claims you pay. The only question is where you intervene — at the implant, or at the $79.95 tool that might keep it from getting there. Fifteen minutes is enough to see what it looks like for your plan.