At West Augusta Dental Associates, we understand the frustration of unexpected dental costs. Dental insurance plans vary significantly in coverage, and several factors may explain why your treatment isn't fully covered.
- Coverage Limitations — Most dental plans have annual maximums (typically $1,000–$2,000) that cap what the insurance company will pay within a calendar year. Once you reach this limit, you're responsible for the remaining costs, regardless of necessity.
- Treatment Classification — Insurance companies categorize procedures into preventive (cleanings, exams), basic (fillings), and major (crowns, bridges) treatments. Major procedures often have lower coverage percentages—sometimes only 50 percent—while preventive care might be covered at 100 percent.
- Pre-existing Conditions — Some plans don't cover pre-existing conditions or have waiting periods for certain procedures, particularly for new policyholders.
- Alternate Benefit Provisions — Insurance may only cover the least expensive treatment option for a particular condition, even when your dentist recommends a different approach based on your specific needs.
- Network Restrictions — Coverage may be reduced if you see providers outside your plan's network.
We're Here to Help!
We're committed to helping you navigate these complexities. Our team can provide pre-treatment estimates, discuss payment options, and work with you to maximize your benefits while ensuring you receive optimal care.
Have more questions about your coverage? Please call your trusted Augusta dentist at (706) 738-8070; our friendly staff will gladly assist you.