It’s common for dentists to have dedicated professionals who understand the complexities of various dental insurance policies. Helping patients navigate the details of their plan allows for stress-free appointments most of the time. However, when companies include a waiting period, it can cause confusion and frustration. What are they, and why do some companies find them necessary?
Waiting Period 101: Getting Down to the Basics
When enrolling in a dental insurance plan, you are likely to assume that you can begin to use your benefits right away. Once you meet your annual deductible, you will pay less out of pocket for the preventive and restorative services you receive. That is the reality, right?
Unfortunately, that is not always the case.
Some dental insurance companies include a waiting period, the time between enrollment and when you can begin using your benefits. This can last up to 6 months or up to 1 year, depending on the company and your plan.
Why Do Insurance Companies Include Waiting Periods?
The idea behind waiting periods is two-fold:
- To keep individuals who need extensive dental care from signing up for a plan and then dropping it after treatment is complete.
- To keep coverage and premiums low for everyone who wants to enroll.
Instead of using dental insurance to access immediate coverage for a serious oral condition, companies want patients to invest long-term. By remaining enrolled in a plan throughout the year, even when your teeth are healthy, you and many others benefit from lower out-of-pocket costs.
Are Preventive Services Subject to Waiting Periods?
In most cases, no. Dental checkups and cleanings are not included in an insurance company’s waiting period. This is because they are preventive services designed to reduce your risk of needing restorative treatment in the future.
However, other services are likely to require a wait time, such as:
- Dental fillings
- Dental crowns
- Dentures
- Root canals
- Tooth extractions
- Dental bridges
- Oral surgery
If your dental insurance plan includes a waiting period, do not be alarmed. Make sure to talk to your dentist about the situation so that proper steps are taken to maintain your oral health until it is time for more extensive care.
About the Author
Dr. Molly Burton brings over 10 years of experience to Magnolia Family Dentistry of Austin. She is committed to personalizing each patient’s visit and getting to know each person on an individual basis. Although she is out-of-network with dental insurance providers, she and our team will file claims to help patients maximize reimbursement and get the most out of their benefits. If you want to understand how your dental insurance works and whether you have a waiting period, contact us at (512) 441-2098 to speak to a member of our team.