If you’re starting a new dental insurance plan this January, you may be surprised to learn that even though your policy is effective, your benefits aren’t completely active just yet. This is known as a waiting period, and many dental insurance plans have them in place to prevent patients from getting expensive treatments on day one and then immediately canceling coverage. Here’s a closer look at how waiting periods work, and when you can expect your dental treatments to be fully covered.
What is a Dental Insurance Waiting Period, anyway?
Dental insurance was designed to protect your smile by providing coverage for preventive oral health treatments like cleanings and exams, X-rays, and fluoride. Unlike medical insurance which pays more to treat illnesses and injuries after the fact, dental insurance doesn’t typically cover restorative or emergency treatment in full. Thus, preventive care is usually available immediately with most plans, and more involved or expensive procedures may not be covered for up to a year.
How Long Do Waiting Periods Last?
While each dental insurance plan is different, waiting periods could last from a few months to up to a year. Fortunately, many employer-sponsored insurance plans do not have waiting periods, but if yours does, there still may be a few ways to cut it short or eliminate it.
One way is if you were recently covered by another dental insurance company, you can submit proof to your new provider that you’ve had consistent coverage.
Furthermore, you can also try purchasing a dental insurance policy from your previous provider directly if the plan offered at your new employer is through a different company. This way, you’ll have a well-established history of coverage, and you shouldn’t need to wait to get necessary care.
Which Dental Treatments Will Have to Wait?
Because each dental insurance plan differs from patient to patient, the best way to determine if your plan has a waiting period is to contact your HR administrator or log into your benefits portal. However, if it does require a waiting period, most treatments fall into these three categories:
- Preventive: While this varies from plan to plan, preventive treatment like exams and cleanings, X-rays, and fluoride are typically covered immediately.
- Basic: This covers things like fillings and other minor restorations and may have up to a six-month waiting period.
- Major: Typically, these are more complex treatments such as oral surgery, root canals, and dentures. It could take a year before they are covered.
What if I Need Treatment Before the Waiting Period is Over?
While nobody wants to need urgent dental care, accidents do happen. If you find yourself requiring a treatment that is not yet covered by your dental insurance, your dental team can help. In addition to welcoming insurance, many dentists now happily accept payment plans from third-party lenders like CareCredit, which can break up the cost of your treatment into multiple, low-to-no interest monthly payments that may be easier on your budget so you can still get the treatment you need before your waiting period is over.
Remember, your new dental insurance was designed to help you prevent a variety of oral health problems, but if your coverage requires you to wait before using it for major work, don’t despair. With the help of your dental team and a little creativity, you can still get the treatment you need without delay!
About Dr. Hegazi
Dr. Mohamed Hegazi earned his bachelor’s degree from Adelphi University and his Doctor of Dental Medicine from Tufts University. While at Tufts, he was granted a Two-Year Health Professions Scholarship with the United States Air Force and became a Dental Officer/Captain for the U.S. Air Force following graduation, where he served for three years and received additional training in oral surgery, implantology, sedation dentistry, and infection control. To schedule an appointment with Dr. Hegazi at Advanced Dental Care, visit our website or call us today at 781-678-4633.