Full coverage dental insurance with no waiting period
When you get a full coverage dental policy, it may not cover every procedure immediately. That’s because many policies have a waiting period — an amount of time between when you enroll and when you can actually receive some benefits. During the waiting period, your dental insurance company may pay for some procedures but not others.
Waiting periods vary and typically range from six months to one year, depending on the plan, insurance company, and the type of dental services needed. Your dental policy should clearly state which procedures are subject to a waiting period and how long until they are covered. For example, the policy may pay for preventive care like teeth cleanings right away, have a 6-month wait for basic care like fillings, and a 12-month wait for major care like crowns. In this article, we’ll explain:
Why do some dental insurance plans have waiting periods?
Waiting periods help control costs: if you shop around, you will likely find that policies without a waiting period for complex care generally have higher premiums than policies with a waiting period. However, a policy with a waiting period may still cost you more in the short term – because (for example) if you have a filling in the first six months, you will have to pay for the full cost; but in the long term, you’ll likely save by paying less each month for coverage. It’s also important to look at the policy’s annual maximum, because it defines the total extent of dental expenses covered each year, impacting the overall value of the plan: a policy with a low annual maximum could leave you with substantial out-of-pocket costs if you need an expensive procedure.
Some services don’t typically have waiting periods, but others do
Dental insurance is often focused on promoting oral health, so even policies with waiting periods usually cover preventive dental care right away. These covered expenses include things like routine cleanings, checkups, routine X-rays, and sometimes fluoride treatments. Dental plans often cover such preventive services in full, with no out-of-pocket cost to you. That’s valuable because these services can help avert more serious and expensive tooth problems in the future. However, services beyond cleanings often require at least a 6-month waiting period. Some policies may make you wait a year for major work, especially for major dental care. The kinds of treatments and procedures not covered during the waiting period typically include:
Basic procedures and treatment: This may include fillings, non-surgical extractions, and other simple services
Major procedures and treatment: Things like bridges, crowns, dentures, oral surgery
Orthodontic treatment: Braces and other types of teeth aligners (if covered)
It’s important to note that these service categories aren’t set in stone. For example, one insurance company might categorize a dental care procedure as basic; another insurance company might categorize it as major. While these categories can give you a broad idea of what’s covered in full-coverage dental plans, you should also look at the plan summary to get more specific details about which basic and major services are covered.
The waiting period can sometimes be waived
You may be able to have the waiting period waived if you can demonstrate continual coverage, i.e., that you've had dental insurance in place with another dental insurance company for at least 12 consecutive months. You will need to supply a letter showing you had prior coverage and a summary of policy benefits from the previous dental insurance company. On the other hand, if you've had a lapse in coverage — even if it was just a short one – you will likely not be eligible to waive the waiting period.
How can I buy dental insurance with no waiting period?
When searching for dental insurance without a waiting period, first try to determine what major services you need right away and how much they will cost. Full coverage dental with no waiting period is available, most commonly in Dental HMO plans, which generally don’t have waiting periods. Depending on the cost of the services you need, these or other no-wait period dental insurance plans may or may not be worth the added premium cost.
Other factors to consider when enrolling in dental insurance
When enrolling in a dental plan, there are two primary things to consider: need and cost. The primary role of a dental plan is to help keep your teeth and mouth healthy, which in turn can help protect your overall health against conditions like heart disease, diabetes, and other health conditions that are impacted by periodontal disease. Dental care can even help mental health and vice versa.1
Think about what services you may need in the not-so-distant future. If you or someone in your family has had dental health issues in the past, look at the insurance policy's plan summary to see if those issues are covered. Even if you don't have a specific concern, you should look at the dental procedures covered. You may not recognize them all—but the longer the list, the better.
Finally, if you have kids, consider a dental insurance plan with orthodontic coverage. If you choose a less expensive plan because the premiums are lower, then skip needed dental work because of the out-of-pocket costs, it will likely cost more in the long run. You could have more toothaches as well.
When choosing a dental plan, keep a few things in mind:
Deductibles: This is the amount you must pay before the insurance plan starts paying for treatments (although many plans waive this for routine preventive visits). It's often around $50 for an individual or $150 for a family — but it can be higher in some plans. With other plans, there is no annual deductible.2
Coinsurance and copays: After you've met your deductible, you may owe a percentage of the fee for each visit to the dentist's office, called coinsurance. Or you may have a flat fee, which varies by treatment — called a copay.
Annual Maximum: The total amount your insurance plan will pay each year. You are responsible for any expenses over that amount.
Coverage options: Some basic plans go beyond preventative care by providing coverage for at least some basic restorative treatments. A mid-level plan should cover preventive care, a range of basic restorative procedures and may offer some coverage for major dental procedures. A quality full-coverage plan provides coverage for routine, basic, and major procedures. Some dental insurance also covers orthodontic work – and if you have children with crooked teeth, you probably want that.
For those who are particular about which dentist they want to see, a plan that offers a Dental Preferred Provider Organization (DPPO) is probably a better option. It offers a wide choice of in-network dentists, but you can still see out-of-network dentists and get some coverage. On the other hand, a plan that offers a Dental Health Maintenance Organization (DHMO) may be better if you need to keep your premiums down. A DHMO may provide more affordable coverage with no deductibles or maximums — and fewer waiting periods — but you have to see an in-network dentist, and the choices may be quite limited.
If you can get dental insurance at work, that's probably your best choice, even if the plan has a waiting period. Employer-provided dental insurance has affordable group rates because they are buying benefits for many employees at once. Compared to individual dental plans, group PPO dental plans often offer higher coverage levels for basic and major services. The employer may also pay a portion of the costs, making it an even better value.
Need to get dental coverage as an individual? There are plenty of affordable options, and it's easy to find and buy online. Just remember that the plan with the lowest premium may not provide the best value for your family's dental health needs. Look at a few sites and compare plan options. Insurance companies should display plan benefits and dental services covered in a simple and straightforward manner.