What Is a Dental Insurance Waiting Period?

A dental insurance waiting period is the time after you begin a new policy and your coverage begins, typically from three to 12 months. 

When you purchase dental insurance, you can heave a sigh of relief knowing that the next major procedure, from a crown or root canal to dentures, should be covered, or at least partially covered. Unfortunately, that's not the full story. You'll have to wait a set period of time after purchasing a new dental insurance plan, called a dental insurance waiting period. Read on to understand how this could affect you and what you can do to ensure you're covered. 

How Does a Dental Insurance Waiting Period Work?

A dental insurance waiting period is the time you have to wait to be eligible for the benefit to kick in. For services like fillings and extractions, this can be anywhere from six to 12 months. That means if you need dental care during the waiting period, you'll typically need to pay out of pocket or pay a higher rate.

The length of the waiting period varies by plan. Preventive or diagnostic service plans typically do not have waiting periods. 

Why Do Dental Plans Have Waiting Periods? 

Dental plans have waiting periods to protect the insurance company's ability to offer the best policies and benefits. By requiring policyholders to keep the policy for a longer period, insurance companies can keep rates lower, as it discourages customers from jumping from plan to plan as convenient or only getting a dental plan before major dental work and then dropping the plan after treatment.  

Instead, dental insurance waiting periods encourage customers to get regular dental treatment and maintain regular preventive checks. The end result should be lower-cost regular dental care and better overall coverage. 

Can You Visit a Dentist During the Waiting Period?

Yes, you can visit a dentist during the waiting period. However, you may need to pay more or all of the costs. Different categories of dental care typically have different waiting periods. The most common are:

Preventive Care

Most preventive procedures, like cleanings, checkups, and X-rays, aren't included in waiting periods. You might be able to get preventive care immediately, or, depending on the policy, it might have a shorter waiting period. 

Basic Care

Basic services typically have a three to six-month waiting period. This includes fillings, diagnostic (non-routine) X-rays, simple (non-impacted) extractions, emergency care for tooth or gum pain, periodontal scaling, root planing, and (in some plans) root canals.

Major Care

If you need major dental work, the waiting period can vary depending on the insurance company and your chosen plan. Services classified as major dental work can vary by policy and company but typically include:

• Dental crowns 
• Inlays or onlays
• Dental bridges
• Dental implants
• Wisdom tooth extraction 
• Complex oral surgery procedures, such as full mouth Reconstruction.
• Anesthesia/sedation

Types of Dental Waiting Periods

Dental waiting periods are also affected by whether you're under an employer-based or individual dental plan. Here's what to know:

Employer-Based Plan Waiting Periods

If you have an employer-based plan, there could be a shorter waiting period, but this varies by plan and individual policy. Additionally, if you had an employer-based policy but no longer work for that employer, you could purchase an individual plan with the same insurer. In that case, the insurer might be willing to waive the waiting period.

Individual Dental Plan Waiting Periods

The waiting periods for individual dental plans can range from three to 12 months. They vary depending on the plan you choose and the insurer's policies. 

How to Find the Right Dental Insurance Plan 

If you're in the market for new dental insurance, getting it as early as possible (before you need care) can help eliminate the waiting period. Learn more about how to choose dental insurance and then use these tips to reduce or eliminate the waiting period. 

Talk to Your New Insurer About Waiving the Waiting Period

Some insurers will waive the waiting period if you've had a comparable dental plan for a significant period. For example, a waiting period might be waived if you've had a comparable dental insurance plan terminated within 30 to 60 days before the effective date of your new plan. However, the former dental plan must include very similar coverage. 

Likewise, if you switch from an employer-based plan to an individual plan with the same insurer, they may be willing to waive the waiting period. 

Choose a Dental Insurance Plan That Offers No Waiting Periods

Some dental insurance plans have no waiting periods. If you need urgent dental care, the additional costs could be worth the overall savings on treatment. 

Consider Dental Insurance Costs 

Even if you have dental insurance, there could be out-of-pocket costs. The different types of insurance costs include premiums, deductibles, copay, and coinsurance. Here's what each of those means:

• Premium: what you pay monthly for your insurance plan
• Deductible: what you may pay before the plan pays for treatment
• Copay: what you pay every dental visit or treatment
• Coinsurance: the percentage of costs you pay after your deductible is paid
• Annual maximum: the maximum amount your plan will pay for dental care in a year

While your insurance policy might not include all of these, they are common terms you might see on your insurance policy. 

Understand In-Network and Out-of-Network Dental Providers

Additionally, you'll have to decide whether you care about the specific dentist you visit. Many dental insurance policies include one price or level of coverage for in-network providers and a lower percentage, or no coverage, for out-of-network providers. 

In-network refers to a group of dentists that accept or are connected to a particular insurance provider or company. While you can usually pay higher insurance premiums to visit any dentist, you could save more on dental insurance by using a dentist in-network with a more limited plan. 

Compare the Best Dental Insurance With and Without Waiting Periods From Benzinga’s Top Providers

If you need dental insurance, Benzinga’s top providers can help you find comprehensive coverage that reduces waiting periods and could help you save more this year. You can also consider supplemental dental insurance. 

Do You Need Dental Insurance?

In most cases, dental insurance can save you more long-term. However, you don't want to change plans annually as you could be regularly caught in waiting periods. While waiting periods protect insurers and patients, they could leave you paying more out of pocket simply because you recently changed plans.

Instead, carefully shop for dental insurance that meets your family's needs and has low monthly costs, low deductibles, or no waiting period. With research and planning, you could get comprehensive coverage or low-cost dental insurance for as little as $22 a month for a full coverage plan. You could also compare costs and consider using a dental savings plan or checking out dental insurance plans for the self-employed.   

Frequently Asked Questions