Why Does Dental Insurance Have a Waiting Period? Dental insurance plans have a waiting period from when you enroll to when the insurance plan starts to pay for procedures. Ann K. Folsom, DMD, in her article about dental insurance for the American Dental Association Family Health Guide, says that the waiting period is “an incentive for patients to seek preventive care and early treatment of dental problems.” That doesn’t mean that you have to wait for a problem to happen before you get it treated. You can still go ahead and take care of your routine checkups, x-rays and cleanings, even if you have to pay for them out of pocket.
When preventive care has been covered but not procedures are covered by the plan, it’s possible that a patient may not want to go through with the treatments they need because they don’t want to spend the money. However, this is a good time to remind people that dental emergencies can quickly become very expensive without coverage. Something as simple as a toothache can turn into root canal without insurance, which could cost thousands of dollars without coverage.
A waiting period also gives insurance companies time to evaluate their costs so they can better price their plans accordingly. The longer the wait period is, the more time they’ll have to see how much it costs to cover people.
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What is a waiting period?
A waiting period is the length of time you have to wait before your dental insurance benefits begin. It’s not uncommon for employers to have waiting periods of up to 12 months for dental coverage. Some states have laws that prohibit waiting periods for any type of insurance, but most dental plans are exempt from these laws.
Why do dental insurance companies have waiting periods?
There are several reasons why dental insurance companies have waiting periods. In some cases, the insurer wants to avoid paying for preexisting conditions. In other cases, the insurer may want to discourage subscribers from dropping their coverage after they’ve had expensive work done.
One common reason for a waiting period is to discourage people from signing up for dental insurance only when they need it. For example, if you know you need a root canal, you might be tempted to sign up for dental insurance just long enough to get the procedure covered. But if everyone did this, it would be very expensive for the insurance company. By having a waiting period, the company can make sure that people are more likely to stay enrolled in their plan for the long term.
Another reason for waiting periods is that they give the insurance company time to process your application and figure out what kind of risk you pose. This information is important in setting premiums and designing benefit plans. If an insurer didn’t have a waiting period, it would be difficult to accurately assess risk and set rates accordingly.
Waiting periods can vary depending on the type of procedure or service being requested. Some services may have a six-month waiting period while others may have a 12-month waiting period. It’s important to check with your dental insurance provider to see what’s included in your plan and what the waiting periods are for various procedures.
How can you avoid a waiting period?
There are a few ways to avoid a waiting period.
One way is to switch to a dental plan that doesn’t have a waiting period. This is especially helpful if you know you’ll need dental work done in the near future.
Another way to avoid a waiting period is to get what’s called “continuous coverage.” This means you have no lapse in coverage for at least 12 months before signing up for a new dental plan. Some dental plans will waive the waiting period if you can show continuous coverage.
You can also avoid a waiting period by signing up for a dental plan during an “open enrollment” period. This is usually offered once per year, and sometimes more often for people who have job-based dental coverage.
If you have questions about whether you can avoid a waiting period, contact the dental plan directly.
Conclusion
The waiting period for dental insurance is in place to protect the insurance company from people who sign up for coverage and then immediately file a claim for a procedure. By making people wait a certain amount of time, the insurance company can be sure that they are only covering people who are truly interested in using their dental benefits.
