All you need to know about Dental insurance waiting period

A dental benefit waiting period is the amount of time after purchasing a dental insurance plan that you must wait before you are eligible to receive benefits for treatment. Waiting periods differ from plan to plan, but there is typically no waiting period for preventive or diagnostic services such as routine cleanings and basic exams.

Conversely, your dental plan may have a 6- to 12-month waiting period for restorative services such as filings and non-surgical extractions, where a 12-month waiting period is often standard for major services such as crowns or dentures. If you receive services during a waiting period, your dental coverage may not pay for them.

The Basics

• The waiting period does not always apply to all benefits; they are usually specific to certain procedures and not routine care.
• The dental insurance waiting periods vary depending on the company.
• Not all dental insurance companies have a dental insurance waiting period.
• Often, employer-based dental benefits plans do not have waiting periods.2
• If you had previous dental insurance, you can present the information to your new dental benefits insurance plan provider, and they may be willing to waive the waiting period in cases where there has been no break in coverage.
• If you are purchasing new dental insurance benefits because you no longer work for the employer who used to provide it for you, you may consider contacting the same benefits plan insurance company and request an individual plan; this may waive the waiting period requirement.

Do All Dental Plans Have Waiting Periods?

No. Waiting periods vary by plans. Some plans may have waiting periods for several covered benefits while other plans may have no waiting periods. To review a state-by-state list of plans without waiting periods, see our article “Dental Insurance No Waiting Periods.”

Additionally, some forms of dental coverage, such as a Discount Dental Plan, are not normally associated with waiting periods. 

Are Some Benefits More Likely to Have Waiting Periods

Yes. While waiting periods are not standardized in the dental insurance industry, expensive dental procedures such as crowns, root canals, dentures, implants, or orthodontic work are more likely to have a waiting period than a less expensive procedure such as a filling or preventive care such as cleaning or x-ray. Preventive care, however, may have an annual limit of two cleanings that must be spaced at least 6-months apart.

How Can I Know if a Specific Benefit Has a Waiting Period?

When you enrolled in your dental insurance, you should have received documentation that describes what is covered by the insurance plan and under what conditions. This document is often called a Summary of Benefits and should explain the various benefits within the dental plan as well as waiting periods if any apply.

How Do Dental Insurance Waiting Periods Benefit You?

Dental insurance waiting periods help keep dental insurance costs under control. They prevent patients from receiving costly dental procedures and then dropping the coverage shortly after, which can result in higher premiums for everyone. Basically, waiting periods help keep dental insurance affordable for all customers.

How do you get around a dental insurance waiting period?

If you’re enrolled in a dental plan that has a waiting period for some services, your only option is to pay for those services out of pocket until the waiting period ends. If you don’t want to get stuck in this situation, you can sign up for a plan that doesn’t have a waiting period.