What Are Dental Insurance Waiting Periods? - Capline Dental Services

What Are Dental Insurance Waiting Periods?

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People often enrol for dental insurance coverage when they are in need of a costly dental procedure. However, they are surprised to learn that they don’t necessarily have access to all the benefits associated with their insurance plan right from day one when the coverage starts. 

The full benefits of a plan are usually available after a certain period of time which may vary from a few months to a full calendar year depending on the type of insurance plan. This period is called dental insurance waiting period and it helps to keep the insurance costs low in the long run for all the parties involved.

Why are dental insurance waiting periods needed?

Dental insurance waiting periods help to encourage people to remain enrolled with the insurance plans for longer periods and to seek regular treatments rather than enrolling last- minute whenever there is a need for any major dental procedure. This is a major concern for insurance companies since most people seek to enrol for insurance plans only as a one-time benefits usage option and opt out of the plan right after the procedure is completed and fully paid for by the plan. This leads to long term losses for the insurance companies and hence the dental insurance waiting period serves as kind of an insurance for the insurances. 

With the concept of waiting period with insurance plans, more and more people carry dental insurance even when there isn’t the requirement of any costly procedure and their teeth are happy. This helps to keep the insurance premiums low for the public and the coverage costs manageable for the insurance companies. Waiting period helps to keep insurance premiums affordable for the people.

Can you visit a dentist during the waiting period?

If your insurance plan has an associated waiting period, it doesn’t mean that you necessarily can’t visit your dentist at all and get the cost of your visit covered by your plan. Dental insurance waiting periods commonly apply to basic and major dental procedures like crown, bridges & dentures, fillings and non-surgical extractions. Most of the preventive care services are covered from day one. 

The procedures having waiting period under your insurance plan would be clearly listed in your benefits summary document. For the procedures listed in this category you’ll have to bear the full cost until the dental insurance waiting period lasts and you can start availing full coverage benefits of your plan. However, the waiting period doesn’t mean that you will have to bear full costs of even the preventive dental care services. In most of the cases, routine care services like cleanings, x-rays and dental check-ups are covered right from the beginning of the plan as these are necessary routine services to prevent the requirement of costly procedures in the long run.

This being said, after the waiting period you have access to full coverage benefits of the insurance plan and don’t have to even pay for the basic and major dental procedures depending on the type of plan you have enrolled for.

Are there any plans with no waiting periods?

Since dental insurance waiting periods are just to encourage people to carry insurance plans for longer durations and not just one-time benefits, it is very much possible for you to avoid the waiting period if you are insured with certain types of insurances over a period of time. These instances are:

  • If you have enrolled in a dental insurance plan with a particular network through your employer and you opt for any other stand alone plan of the same insurer then the insurer might waive of the waiting period for you.
  • If you enrol for a new insurance plan and you were already enrolled in a dental insurance plan with no break in coverage before opting for the new plan, your insurer might completely waive off the waiting period for you in the new policy.

Waiting Periods Help you lower the Dental insurance costs in the long run. Though at the outset, the waiting period might seem as an unnecessary hassle for the public and as a means to delay the benefit coverage, however, in the long run it helps to keep dental insurance costs in check and curb the insurance premiums considerably. The longer the waiting period, the lower is the insurance premium. 

However, to be able to make the most of such a benefit you need a regular enrolment with any relevant dental insurance plan and to maintain a healthy oral routine so that any requirement of complicated dental procedures never comes unplanned.