Your new dental insurance plan was specifically designed to help make your routine and restorative oral healthcare more affordable. But although it may have taken effect on January 1, that doesn’t necessarily mean you can start using your full coverage on day one. Here’s a closer look at why your policy may have a waiting period, and when you can begin to enjoy all its perks!
What Are Dental Insurance Waiting Periods?
Unlike medical insurance which was designed to provide coverage for treatment after a problem has occurred, dental insurance was created to lower the cost of preventive oral health care before an issue has the chance to develop. The good news is that this means that often, coverage for treatments like your biannual exam and cleaning begins immediately. Unfortunately, however, some plans have a waiting period of up to a year before more expensive and complex treatments like dentures, extractions, and root canals are covered. This clause is typically put in place to prevent policyholders from buying a plan, getting a bunch of costly dental work, and then canceling it when their procedures are complete.
How Long Will My Waiting Period Last?
Dental insurance waiting periods can last anywhere from a few months to up to a year. While not every plan will have a waiting period (including many that are employer-based), there are sometimes ways you can petition your provider to have them waived completely. For example, if you’ve been previously covered by another provider, you can submit proof of this to your new insurer, and they may eliminate the wait. You can also purchase a plan directly from your previous provider if you have recently lost employment-based coverage to avoid delays.
Which Treatments Will I Have to Delay?
Because each dental insurance plan is different, the duration of each waiting period will vary from patient to patient and depends on the type of work needed. Most dental work typically falls into one of the following three categories:
- Basic: Coverage for things like fillings and other minor restorative treatments could have up to a six-month waiting period, while “major” treatments could have delays of up to a year.
- Preventive: Depending on your plan, these treatments (such as dental exams and cleanings, fluoride, and X-rays) may not have any waiting period and coverage could begin immediately.
- Major: The definition of major depends on your specific plan, so be sure to review the details for more information. Generally, this refers to more complex treatments like root canals, oral surgery, and dentures, and coverage could take a full year to kick in.
What if I Can’t Wait?
While your dental insurance plan may not give you much of a choice about waiting for your coverage to take effect, your smile may have different plans. Thankfully, your dentist might offer alternatives to dental insurance to help make urgent treatments more affordable, such as in-house membership programs and flexible financing plans. These generally do not have waiting periods and can be used on a variety of treatments from preventive to restorative.
Remember, if you’re starting a new dental insurance plan this year, congratulations on taking the first step towards protecting your smile. Be sure to review the details in advance so you know what’s covered and when, and if you need any help understanding your policy, reach out to your benefits administrator or your dentist’s friendly dental insurance team for more information.
About Our Practice
At Brooklyn City Dental, we welcome a variety of dental insurance plans designed to protect your teeth and gums for a lifetime of smiles. If you’ve recently gotten a new policy, your plan could have a waiting period for certain treatments. Let our team assist you in figuring out what’s covered so you can get the care you need without delay. To schedule an appointment or with dental insurance questions, visit our website or call us today at 718-725-7732.