Dental Insurance

Dental Insurance

Frequently Asked Questions About Dental Insurance

1. What is dental insurance?

Good question! And a very important question!

Most of us are familiar with our medical insurance benefits, where we have fixed copays, deductibles, and maximums. No matter what medical doctor or specialist you need to see, your medical expenses are covered as soon as you meet your out-of-pocket limit, and the maximum coverage for each year can reach over one million dollars!

Dental insurance is much different.

Dental insurance operates more like a coupon for dental treatment. It often covers or provides large discounts for routine and preventive care, with limitations on coverage for more extensive procedures. Compared to medical insurance, dental insurance annual maximums are extremely low (usually $1000-2000), and the maximums have not changed in decades! 

It is important to know that dental insurance is a cost-saving tool rather than comprehensive coverage for all dental expenses.

2. Okay, so do you take my insurance? 

Yes! We will accept and file almost any dental insurance. 

Depending on your insurance plan, some dentists will be considered in-network, and others will be considered out-of-network. Most dental insurance plans will allow you to choose your own dentist, meaning they will allow you to see an in-network dentist or an out-of-network dentist.

An in-network dentist has signed a contract with a dental insurance company to provide dental care at a negotiated (reduced) rate. Unfortunately, dental insurance companies do not exist to help patients - they exist to make money - so the reimbursements are often so low that they don't even cover the cost of materials needed to complete the treatment! Reimbursements increase by (literally) pennies every year, while the costs for quality materials, equipment, and dental labs have skyrocketed. That means that we are unable to provide certain necessary treatments to our patients. 

In other words, your dental insurance company is telling you and your doctor what treatment you can or cannot receive. In-network dentist are trying to help their patients, but they have to cut costs to meet insurance demands. They often do this by using inferior materials, equipment, and labs. We think our patients deserve better than that!

Advanced Dentistry of Augusta is considered out-of-network for most dental insurances. We choose to be in-network with a select few insurances whose reimbursements are reasonable enough to not dictate our diagnosis and treatment.

3. Why would anyone choose to go to an out-of-network dentist?

In addition to the reasons above, choosing to visit an out-of-network dentist instead of an in-network one can often lead to a more personalized and comprehensive dental experience. Out-of-network dentists typically have more freedom in their practice, allowing them to prioritize individual patient needs over insurance constraints. This can result in a higher level of attention to detail and a more thorough assessment of oral health concerns. Additionally, out-of-network dentists may offer a wider range of treatment options, including innovative techniques and advanced technologies that may not be available within the limitations of an in-network provider. By opting for an out-of-network dentist, patients may have access to cutting-edge treatments that can lead to improved outcomes and overall satisfaction with their dental care.

Out-of-network providers typically prioritize quality of care and patient satisfaction, focusing on delivering tailored treatment plans that address individual needs and preferences. This personalized approach can lead to better long-term oral health outcomes and a more positive overall dental experience. Additionally, by investing in comprehensive care from an out-of-network dentist, patients may ultimately reduce their need for costly dental procedures in the future, making it a prudent choice for those prioritizing both their oral health and financial well-being.

4. So you have patients who come to your office, even though you're not in their insurance network?

Yes! We have thousands of patients, and almost all of them choose to see us even though we are considered out-of-network. These patients see and understand the advantages of seeing an out of network dentist.


5. Will I have to pay more to see an out-of-network dentist?

Every insurance company and insurance plan is different, so it is important to contact your insurance company to understand your benefits. As a punishment for not accepting their unreasonable reimbursements, dental insurance companies often refuse to provide benefit information to out-of-network dentists, but they will provide that information to you, the subscriber.

However, any difference in out-of-pocket costs are often minimal, and well worth it! Insurance companies will often even pay more for treatment with out-of-network providers!

Our skilled team will maximize your insurance benefits and provide you with estimates for what your insurance company will contribute towards your care.

Just remember - we want what's best for your health and want you to achieve chewing and smiling success! 


6. What if I don't have dental insurance?

No worries at all! Advanced Dentistry of Augusta has a dental membership plan called Pleasant Care!

Just like Amazon Prime, you pay for an annual membership, and receive the benefits all year long! Your membership includes your dental cleanings, exams, x-rays, a discount on treatment, and even an emergency exam should you need it. Give us a call or stop by to learn more!

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