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Why Do Dental Insurance Plans Have Waiting Periods?

Your dental insurance is a monthly investment that allows you to benefit from reduced rates for the services you need to keep your teeth and gums healthy. After purchasing your policy, you might be surprised to learn there are dental insurance waiting periods that might limit the services you can receive. Don’t worry, they don’t last forever. Although they may seem unnecessary, here’s what you need to know about your coverage and maximizing your benefits.

Understanding Dental Insurance Waiting Periods

Your dental insurance focuses on prevention to keep your smile healthy. Research shows routine dental care lessens the likeliness of needing a costly treatment down the road; however, if an issue arises, your benefits can be used to help offset the amount you pay out-of-pocket. Although every plan differs, most policies include:

  • 100% preventive care
  • 80% minor restorative care
  • 50% major restorative care

After purchasing your policy, you might have a length of time you must wait before you can use all your coverage. The waiting period can vary from a few months to a full year depending on your specific plan. That doesn’t mean you can’t use your dental insurance. Instead, there are some benefits you may not be able to utilize right away.

Facts about Waiting Periods

It’s not a secret dental insurance can be confusing. Here are the facts you need to know to better understand your policy to make the most of your monthly investment:

  • Routine services aren’t always included during the waiting period.
  • Not all dental companies have waiting periods, like employer-based plans.
  • If you’ve previously had dental coverage but switched to a new provider, they may waive the limitations.
  • If you’ve changed employers but have the same benefits plan, there may not be a waiting period.

Using Your Benefits During Waiting Periods

The dental insurance company establishes waiting periods to ensure a person isn’t just purchasing the plan to cover oral health issues that have accumulated over the years. As a result, it lessens the likeliness the coverage is dropped after the treatments have been performed.

Typically, only certain services are included during the waiting time depending on the category they fall under, such as:

  • Basic: Basic services can have a 3 to 6 month waiting period, while any major treatments can require 6 months to 1-year, such as dentures.
  • Preventive: Most preventive procedures aren’t included in waiting periods, like cleanings, checkups, and X-rays.
  • Major Work: The services classified as major dental work can vary from company to company.

Invest in a Healthy Smile

If you’re concerned about any limitations with your coverage, your dentist will help you find the solutions you need to navigate your plan to achieve the healthy smile you deserve.

About Dr. Greg Ritchie

Dr. Ritchie earned his dental degree at the University of Texas Health Science Center. He has completed advanced training in many specialties, such as implant dentistry. He works with many leading insurance companies to keep his services affordable. If you’re ready to utilize your dental benefits, contact our office today to schedule an appointment.


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