Now We Wait: What is the Point of a Dental Insurance Waiting Period?

After visiting your dentist, you recently discovered that you need a custom-made dental crown to protect a vulnerable and decayed tooth. Recognizing the importance and need of receiving timely care, you begin the process of filing a claim with your dental insurance company. However, you learn there is a waiting period for this type of treatment. Why? If you’re like most people wondering why you have to hold off until your insurer gives you the green light, read on.

What is a Waiting Period?

In the simplest terms, a waiting period is the designated amount of time an insurance company sets before you can take advantage of complete coverage. This timeframe can vary from plan to plan but may only last a few months or an entire year.

It’s important to review the plan you’re considering before purchasing especially if you don’t want to wait long (or at all) to receive essential oral healthcare.

Why are Waiting Periods Necessary?

Not many patients understand the point of waiting periods, but dental insurance companies do have a reason for using them.

For example, the most common reason they are incorporated is that these companies do not want individuals to purchase a plan, get the care they need at a lower rate, and then cancel their coverage after their treatment is complete.

By adding a waiting period, patients are more likely to stay with their insurance company for the long term.

Are There Stipulations That Come with Waiting Periods?

Yes, it’s important to remember a few things when it comes to waiting periods:

• It’s unlikely that a waiting period will apply to all available benefits. They’re usually only attached to certain treatment options, such as root canals, tooth extractions, or more extensive care. Some basic procedures may require a six-month waiting period, while more complex ones may have a six-month or one-year waiting period.
• If you have an employer-based dental insurance plan, there’s a good chance a waiting period will not be included.
• Routine (preventive) care is unlikely to have a waiting period, so you can move forward with dental exams and checkups twice each year.

While a waiting period may not be something you want to see as part of your policy, know that it is there for a reason. If you want to avoid it altogether, make sure to review your proposed plan before purchasing it through your employer or independently. This will ensure you get the treatment you need much faster.

About the Author
Dr. Diana Vazquez studied at Baylor College of Dentistry, earning her dental degree before going on to receive advanced training in pedodontics, removable prosthetics, restorative treatments, and oral surgery. Alongside her colleague and friend, Dr. Jose Aldana, the two are pleased to provide affordable dental care for patients in Mesquite and its surrounding areas. We are in-network with countless insurance plans and will always do our best to maximize your dental benefits, so contact us at (972) 288-3200 to learn more about how we can help.