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What are Waiting Periods & How Can They Affect Dental Coverage?

May 16, 2024

Filed under: Uncategorized — drsongfm @ 4:51 pm
a dental front desk staff handing patient forms

Dental insurance can be incredibly difficult to figure out, not only because every plan is unique, but also due to all of the complicated jargon that feels impossible to navigate on your own. Fortunately, you don’t always have to do this solo! Many dental teams consist of staff that will file claims on your behalf and help you better understand the limitations of your individual plan, like if you have a waiting period. Read on to learn more about how waiting periods work and whether they’ll impact your coverage for future appointments.

What are Dental Insurance Waiting Periods?

Waiting periods don’t always apply to all of the benefits offered by your dental insurance plan. They typically apply to procedures outside of routine preventive care, like crowns, fillings, root canals, etc., and the average waiting periods lasts for between six and 12 months; however, this can vary depending on your insurance company. Once the waiting period is over, you’ll have access to your full benefits.

Why Do Some Dental Insurance Plans Have Waiting Periods?

Waiting periods are applied to certain dental insurance plans, typically HMO plans, to keep patients from attempting to receive several major treatments at once, as soon as they become insured. As unfortunate as they are, dental insurance companies typically apply them to try to keep payouts lower, and in turn, keeping premiums low, which is the monthly amount that you pay for your dental insurance.

While plans with waiting periods certainly have their downsides, they are a great way for patients who don’t receive coverage through an employer to be able to afford dental insurance.

Can Dental Services Be Covered During Waiting Periods?

It’s typically the case that waiting periods don’t apply to routine dental care, including six-month checkups and cleanings and routine X-rays. However, every plan is different, and it’s best to check with your insurance company or consult your benefits packet before scheduling any appointments.

After your waiting period ends, your benefits will be able to apply to other services. In many cases, insurance plans will cover the partial costs of basic restorative dentistry, like fillings and dental crowns, as well as a portion of the cost of more major work, like gum disease treatment, dentures, bridges, and tooth extractions.

Although the ins and outs of dental insurance can be complex and frustrating to navigate, you don’t have to do it alone. Your trustworthy dental team will walk you through everything you need to know and provide you with a detailed cost estimate before any work is done, making sure you don’t get stuck with any surprise bills!

About the Author

Dr. Rodger Song has been helping patients access affordable dental care for over 30 years. His team is highly capable when it comes to helping patients maximize their dental insurance coverage and minimize out-of-pocket costs. He’s a proud in-network provider with a variety of PPO dental insurance plans, including Guardian, Humana, Principal, United Healthcare, Delta Dental Premier, and more. To learn whether you’re in-network with Bridlewood Dental of Flower Mound, visit our website or call 972-906-9797.

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