Insurance

Insurance Companies We Do File With

Almost Any Plan Not Listed Below.

**We currently are not in network with any insurance providers.**

Insurance We Do Not File With

If you have one of these plans and choose us as your dental provider, then you will have to pay out of pocket.

Medicare / Medicaid / Payment Plans

Wellcare

Amerigroup

Frequently Asked Questions

Here at Dr. Hall’s office, we are committed to helping you use your insurance benefits. We file most dental insurance plans and will assist you in obtaining the maximum benefits your plan provides. Even though we are not in a dental insurance network, meaning we are out-of-network, we’ll gladly process your insurance claim for you and estimate the portion that is not covered by insurance. This co-payment amount is due at the time of treatment and may be paid with check, cash, any major credit card or Care Credit.  Dental insurance is an excellent tool for offsetting the cost of dental care and we are committed to helping you obtain your benefits and minimize personal payments for care.  Listed below are some commonly asked questions about dental insurance.

“Why aren’t my exams and cleaning, among other procedures, 100% covered like my plan says?”  The insurance company typically allows 100% as payment for the procedure. It isn’t always what the dentist may charge. An insurance company may allow $60 as payment for an exam, but the office fee is $80. This leaves $20 that the patient is responsible for.

“It’s been less than 6 months since my last cleaning, will my insurance cover this cleaning?”  This depends on your insurance company and your specific plan.  We recommend contacting your insurance company to double check how they cover your cleanings and if there is a certain time that you need to wait between each cleaning.

“Is there a waiting period for my insurance?”  Most dental insurance policies have waiting periods ranging from six to twelve months before any standard work can be done. Waiting periods for major work are typically longer and can be up to two years. These periods are set in place by your insurance company and we recommend contacting them to find out what your waiting period is before completing any dental work.

“Can I do anything if my insurance doesn’t cover the treatment I need?”  The coverage is between the patient, the employer or provider, and the insurance carrier. The dentist has no power to make the carrier pay for recommended treatment. If the insurance refuses to cover the treatment, the balance is the responsibility of the patient.

“Do I have a yearly maximum?”  While most medical insurance policies have yearly out-of-pocket maximums, the majority of dental policies cap the amount of annual coverage. Coverage maximums typically range from $750 to $2,000 per year and generally speaking, the higher the monthly premium, the higher the yearly maximum. Once the yearly maximum is reached, patients must pay for 100% of any remaining dental procedures.

“Do I have a deductible to meet?”  In dental insurance, it is common to have an annual deductible for each individual on a policy, as well as for your family. Similar to car insurance, this is the amount you pay before your benefit plan begins to pay the cost of your dental treatment.

“Does my insurance cover cosmetic procedures?”  Most dental insurance policies do not cover any costs for cosmetic procedures such as teeth whitening, tooth shaping, veneers and gum contouring. Because these procedures are intended to simply improve the look of your teeth, they are not considered medically necessary and must be paid for entirely by the patient.
While we think insurance is a great thing, we understand it can be a complicated and frustrating thing.  To better understand your insurance, we recommend calling the number on the back of your card and taking the time to speak with a representative.
As another option to dental insurance, we do offer an in-office discount plan.  There is a one time enrollment fee and after that a monthly fee (or you can pay the yearly total in full if you prefer).  The plan covers all of your cleanings, preventative care, x-rays and a discount towards any restorative work.  This plan cannot be combined with any other dental insurance and is only offered through this practice.  If this is something that you think you may be interested in learning more about, please feel free to contact us at 706-549-8737.  We appreciate you taking the time to read this and as always, we look forward to seeing you soon!
Sincerely,

Brian P. Hall, DMD