15 Jan Dealing With Waiting Periods
Some patients may have to endure waiting periods during which they have no coverage for certain treatments after a set period of time (Araujo 2018). Dental insurance companies utilize waiting periods in order to prevent people from enrolling into their plan, using its benefits for their procedures, and immediately leaving the plan “after the dental insurance policy has expired” (Araujo 2018). While patients can usually access preventative procedures without waiting periods, they may have to wait 3 to 6 months for coverage on “Basic procedures” and 6 to 12 months for coverage on “Major procedures” (Araujo 2018). Additionally, people may have to wait before receiving benefits for any preexisting conditions, which are conditions present before they bought their policy (Goodell 2018, 2; Haney 2018). People have to enroll into these policies early in order to utilize most of their benefits at the outset for any unexpected conditions they may experience in the future and/or finish the waiting periods sooner (“Which Types of Dental Insurance Cover Everything?”). Patients can either find ways around waiting periods or pay for treatments affected by waiting periods through other means.
Insurance companies can reduce or waive waiting periods depending on different factors. People that enrolled into new individual dental insurance plans can have no waiting periods on “Major procedures” if they can prove they “had prior qualified coverage” (Haney 2018). People that can verify this include those “who recently lost coverage after changing employment or other reasons” and “[those] with existing plans seeking a second policy…” (Haney 2018). People can also immediately receive coverage for their pre-existing conditions “if the applicant can verify that the old plan expired no more than 60 days earlier” (Haney 2018). Alternatively, they can also decrease “the length of the exclusion” for benefits on pre-existing conditions based on “the amount of any prior creditable coverage. Most coverage can be considered creditable coverage, including group dental coverage, COBRA continuation coverage, or coverage under an individual dental policy” (“Typical Dental Plan Benefits and Limitations”).
Alternatively, people could pay for treatments not covered by dental insurance due to a waiting period through different means. Patients should not wait for the end of the period in order to get coverage for “Major procedures” because their condition could worsen, resulting in more expensive treatments, and insurance usually only pays up to 50% for these procedures (Araujo 2018). Along with that, annual maximums could limit the coverage for treatments whose waiting period ended (Nefer 2017). Instead, medical insurance could cover procedures, such as emergency treatments, “antibiotic treatment before a root canal,” and “portions of any oral surgery expense,” without waiting (Haney 2018). Patients can pay out-of-pocket for treatment on a payment plan (Araujo 2018). Also, instead of dental insurance, people can use discount plans for reduced costs on treatments for conditions that would be considered pre-existing conditions (Nefer 2017).
While waiting periods restrict coverage, people have many ways to reduce or waive them. Others can pay for them by utilizing medical coverage or other payment methods.