I was born missing teeth 7 & 10 (aka the ones between the front and eye teeth on the top jaw), had braces, now trying to get permanent implants. My dental insurance is claiming they don't cover implants, but the paperwork says they cover both:

1) "major restorative surgery – Includes: crowns; inlays; prosthetic services; removable, complete and partial dentures; fixed bridges; crowns or inlays used as abutments. Replacements covered after five (5) years from appliance date of service"

2) "fixed & removable prosthodontics – Includes: permanent dentures, fixed bridgework and removable partial dentures, posts if evidence of root canal therapy on the tooth, pins once every six (6) months. Replacements covered after five (5) years from date of service. Insertion of fixed bridge and partial denture in same arch covered after five (5) years from date of service. Adjustment of appliances is covered after one (1) year of insertion."

Has anyone had any luck 'fighting' their insurance to cover implants in a similar case? I'm not sure what a 'prosthetic service' is if not…implanting a prosthetic tooth. I've had Maryland bridges for ~7 years now to hold the gaps, I had to put off getting anything done during the pandemic then I lost dental insurance for a while, and I'd really like to get the ball moving again but the representatives seem to be running me in circles. Thanks in advance for any advice!

submitted by /u/myinstrumentconfuses
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