Did My Dental Insurance Fail to Cover Medically Necessary Sedation for My Child’s Procedure?

I recently took my 4-year-old to the dentist for a procedure involving multiple stainless steel crowns. Since my child is young and wouldn't have been able to sit through the treatment without help, the dentist had to use non-IV conscious sedation. I was charged $430 for the sedation, which my insurance didn’t cover, even though it was essential for the procedure to be completed.

I have the UT SELECT Dental Plus plan, which covers many dental services, including:

• Preventive and diagnostic care at 100% (cleanings, exams, etc.)
• Basic and restorative services at 100% (fillings, extractions, etc.)
• Major procedures like crowns at 80%

However, sedation seems to only be covered in certain oral surgeries (like gingivectomy or osseous surgery), but not for pediatric procedures like this one. Here’s what happened:

• The crowns were covered properly, but sedation wasn’t, and I had to pay the full $430 out of pocket.

I’ve spoken with the insurance company, and they mentioned I need to wait for the Explanation of Benefits (EOB) before I can appeal. Has anyone had success appealing coverage for necessary sedation in pediatric dental procedures? Any advice would be appreciated!

Thanks for the help!