Dental Insurance Decoded: What is a Waiting Period? | Solstice

Dental wellness is essential to overall health. However, many people go uninsured. Luckily, dental insurance is more accessible than ever, and multiple options are available. That said, it's essential to understand what you're signing up for.

Some dental insurance companies have a "waiting period" policy for new members. There is worry that people will only purchase a plan for a particular time or when they have a dental emergency. So, companies impose a waiting period to prevent the "buy, use, cancel" cycle. This means you can only use your benefits after a certain amount of time passes. 

The time you must wait varies depending on the dental company and your plan. It can range from six months to as long as two years. 

We will closely examine how these waiting periods work and what you need to know before you go.

Five things to know about dental insurance waiting periods: 

1. Routine preventive services prevent more serious oral problems. So they are covered immediately. These include check-ups, x-rays, and cleanings.
2. Basic procedures may require waiting a partial period of approximately six months. This includes fillings, having a tooth pulled, and treatment for gum disease.
3. Major services, like dentures or dental implants, are more costly. Because of this, these procedures typically have the longest wait time. Depending on your provider, coverage could take up to twelve months.
4. In some cases, the longer you wait, the lower the premium for the insurance.
5. Not all insurance companies require their members to wait. Be sure to check all the details about any wait time when shopping for or enrolling in a dental plan.

Example of how dental insurance waiting periods work

Hanna needs a crown. She contacts her dental insurance company to see if she is covered for the procedure. Her insurance company tells her that she does not have any coverage for the procedure since she has only had her dental insurance for three months, and any crown procedures have a 6-month dental insurance waiting period. Once the time has elapsed, dental benefits will be fully accessible to her.

Whether your insurance provider requires you to wait for services or not, there is no question that dental insurance can save you money on treatments and surgeries. 

When does a waiting period not apply?

There are times when a dental waiting period may not apply. Examples where you may not need to wait for treatment include:

• Changing plan types with the same insurance company
• Rolling over your employer-based dental plan to select an individual plan from the same insurer
• Selecting a dental insurance plan that has no waiting periods

Are there different types of dental waiting periods?

The time you must wait for dental care can change based on the type of plan you have.  

If you have a plan through your employer, there will be a start date. Your treatment will be covered after that time. Your employer may also have a waiting period for certain services, typically for basic and major procedures.

For individual dental plans, you may be able to receive treatment immediately. However, there can also be a waiting period to receive certain services.

There can also be waiting periods based on previous dental work. Suppose you started a dental procedure with another dental plan. Your new dental insurer may not cover the completion of that procedure. If you require repairs or a dental appliance (bridges, implants, etc.), there could be restrictions if it is related to a previous procedure. 

Is the waiting period the same as a deductible or copay?

It's important to note that the dental waiting period differs from the deductible and copay. These are the costs you may be responsible for when receiving treatment. 

Read the policy carefully if you have dental insurance or want dental coverage. You will need to understand the waiting period and other important details. The more you know, the better your position will be to make the best choices for your dental health.

If you're shopping for a dental plan with no waiting period and need instant coverage, sign up for a Solstice dental savings plan! Click the image below and get a month FREE!

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