What is the difference between Eligibility Date and Effective Date in Dental? - Capline Dental Services

What is the difference between Eligibility Date and Effective Date in Dental?

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Eligibility date or billing date is the recurring monthly date on which you are charged the monthly insurance premium. The dental eligibility verification date is established on the day the application is submitted and approved. It also acts as the date for recurring billing for each month. 

On the other hand, the effective date is the date on which the benefits of the plan come into effect. It varies from plan to plan as well as depends on your insurance carrier. In most cases it is usually the next day after enrollment. 

As a result, once a person reaches their effective date of their dental coverage, they can start using the benefits covered in their policy. 

In what case can patients not use their benefits even after the effective date has come into effect ? 

It can easily happen that a person reaches his/her effective date but is still unable to receive the benefits with respect to the dental treatment he/she wants. This happens when their insurance carrier has enabled a waiting period on their policy. The waiting period refers to the amount of time one has to wait for before the person who has taken the insurance plan can start using the services covered in the plan. This is why it is important to check for the waiting period duration in your plan even after the effective date has come into action. It is because if you get some treatment done, say routine examination or a more expensive one like tooth extraction then these will not be covered by your insurance plan if the waiting period has not been waived. 

Moreover, if the waiting period is of a certain time then it is advisable to ask the dentist for a rough estimate of the cost of the treatment you seek as it can easily prove more costly to delay treatment.  

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