Dental insurance can be confusing. Period. It doesn’t help that there are so many terms you don’t typically come across in your day-to-day life. “Waiting period” is one of those terms that can trip people up and also happens to be vital to figuring out how much coverage you can expect for your appointment. Let’s talk about it so you can schedule accordingly and save money on dental care!
What Does it Mean if I Have a Waiting Period?
A dental insurance “waiting period” is often defined as the amount of time policy holders have to wait before they can start receiving coverage for certain treatments. But what does that mean, exactly?
The best way to explain is with an example. Let’s say you have a brand-new dental insurance policy that will take effect on January 1st of the upcoming year. If your policy has a 30-day waiting period (which is fairly common), you won’t be able to actually use your coverage until February 1st. Any treatment expenses you “rack up” in January will have to be paid completely out-of-pocket.
Why Do Dental Insurance Companies Enforce Waiting Periods?
This is a perfectly reasonable question to ask. Dental insurance companies that enforce waiting periods are often trying to avoid a scenario where a patient takes advantage of coverage for an expensive procedure and drops their insurance immediately afterwards. Their logic is that by preventing this with waiting periods, the company maximizes their profit margin, enabling them to keep premium costs low.
Basically, a dental insurance company would likely say that ultimately, waiting periods help make dental insurance more affordable for more people.
Possible Exceptions to Your Waiting Period
Now, there are situations where a dental insurance period might be waived. Most companies exclude routine checkups and cleanings from this rule, for example, and only apply a waiting period to more complex treatments. Some plans don’t even have a waiting period to begin with!
Other possible exceptions include:
- Switching to a new plan without a break in coverage. If you time the transition smoothly and show your previous insurance information to your new provider, they may waive the waiting period.
- Employer-based plans often don’t have waiting periods.
- If you leave a job where you had an employer-based plan, talk to the dental insurance company about changing your policy to an individual plan. They’ll likely make the switch without considering it a break in coverage.
As you can see, dental insurance terms can vary from plan to plan. It’s important to read the details of your policy as closely as possible so you can be aware of the “fine print.” Remember, though, that you’re not alone in navigating your benefits. Your dentist is happy to help you save money on the quality care you deserve, even if that means reviewing a complex dental insurance plan!
About the Author
Dr. Mariya Barnett is adamant about providing the highest level of dental care. She and her team make it a point to be transparent about the cost of treatment and are considered in-network with some of the most popular PPO dental insurance plans. To maximize your coverage and save money on quality dental care, contact Dr. Barnett’s office at 469-874-0469.