Man says insurance called his crown and implant ‘cosmetic,’ so he paid nearly $6,200 cash: ‘It’s a scam from the get go’

A dental patient says his insurance company refused to pay for two dental procedures. He says he paid nearly $6,200 out of his own pocket instead, and that paying cash cost less than what he put into his insurance.

In a video posted to TikTok, creator The_Journey76 says the dispute involved a crown and an implant. His insurer denied coverage for both, calling them cosmetic. “They said, no, this is cosmetic, you don’t need them,” he says in the clip.

The crown reportedly cost $2,200. The implant ran him almost $4,000, he says. He needed the work regardless of what his insurer decided. “I’m not gonna have a missing tooth and I’m not gonna have a cracked tooth,” he explains.

He says the numbers favored paying cash

He says paying cash was far cheaper than using his insurance, and that the cash price was just a third of what he would have paid through his plan, similar to another patient’s experience. In one recent case, a woman said she was quoted $1,200 for a procedure through her insurance but learned she could get it for $480 without using her coverage.

He then started adding up what he’d actually spent on his dental insurance. He compared those premiums with what he’d ultimately paid for the dental work. “I figured up my monthly payment at the end of the year for paying for my dental insurance,” he says. “I could have paid for those things out of pocket and paid less than what I paid into my insurance.”

“It’s a scam from the get go,” he says. “It’s an absolute Ponzi scheme.” He also claims BlackRock, State Street and Vanguard “own them all,” referring broadly to insurance companies. He does not provide a source for that claim in the video. 

Several commenters shared their own experiences with insurance costs. One commenter said they were quoted $14,000 for jaw surgery, then paid $2,500 after dropping insurance and taking the uninsured discount. A third described a full-mouth extraction with implants, saying the insured estimate came in near $50,000 compared with roughly $13,000 paid in cash for what they called the same care. Prices and coverage vary by plan and provider, and the commenters’ figures could not be verified.

As of now, The_Journey76 hasn’t said whether he’s appealing the denial or exploring alternate dental coverage. The insurer has not been named, and its reason for denying the claims could not be verified.