The date of your dental appointment can matter when it comes to dental insurance. Here’s why.

Whether it’s regular cleanings, having a root canal or getting a cavity filled, taking care of your oral health helps keep the rest of your body healthy. For example, regular teeth cleanings can help prevent gum disease, which has been linked to heart disease and diabetes.

Supplemental dental insurance can help you cover the cost of dental services and ease budget concerns. (It’s supplemental, which means you’ll have to pay extra for it, in addition to your traditional health insurance plan.)

But before you schedule an appointment with your dentist, it’s important to understand the details of your plan. You might not be aware that the date of a service may affect whether your dental insurance will pay for it.

Let’s look at why timing matters and what it means if your dental plan has a waiting period.

Did you know that routine exams, cleanings and more may be covered by dental insurance? Explore dental insurance now.

What is a dental insurance waiting period?

Your dental plan will describe not just what services it covers but also when they’re covered. If you have a waiting period, you need to wait until a certain date before coverage of some types of dental services kicks in.

The date is usually a set number of months, often 4 to 12 months, after the day your plan takes effect. There are dental plans with no waiting periods, but others have them. It just depends on the plan.

How does a waiting period affect your dental coverage?

If your dental plan has a waiting period before coverage starts, the waiting period may be different for different types of services.

Dental services are typically grouped into the following categories:

• Preventive services such as exams, X-rays and teeth cleanings, as well as fluoride treatments if you’re younger than 16. (Fluoride is a mineral that helps prevent cavities.)
• Basic services such as simple fillings and extractions.
• Major services (may be limited) such as crowns, complex extractions and root canals. Bridges, dentures and partials, and implants may be covered. But it’s a good idea to check your plan for exclusions.
• Orthodontia (may be excluded), which is the type of dentistry that deals with teeth- and jaw-related issues that may be corrected with things like braces.

Dental plans typically have no waiting period for preventive services. This means you can start using your preventive care benefits as soon as your insurance goes into effect and receive benefits.

For example, your plan may cover an exam and cleaning every 6 months. You may have an exam and cleaning on the first day your coverage is effective. You don’t have to wait for it.

But your dental plan might have a waiting period for basic and major services, as well as orthodontia (if your plan covers it). This means that during a predetermined period, you will pay the entire cost of the dental service out of pocket.

Some of our dental plans offer coverage without waiting periods for preventive, basic and major services. Browse available dental plans online.

Waiting until a waiting period is over may save you money

Once a waiting period is over, coverage starts according to your plan’s benefits and limitations.

You most likely will have out-of-pocket costs, which may include:

• Your premium, which is the amount of money you pay monthly for dental insurance.
• A deductible, which is the amount you pay out of pocket before the insurance starts paying for covered services.
• Copayments, or copays, which is a set amount that you pay for a covered dental service, such as an X-ray.
• Coinsurance, which is a percentage you pay for services after you’ve met your deductible.
• Charges that exceed the network negotiated rate or the reasonable and customary charge.

A maximum amount of coverage may also apply to different types of services for a plan year or during the length of your policy. For example, the plan may cover $1,000 total for orthodontia. After you reach that maximum, you’re responsible for additional costs.

Here’s an example of how you might save money once a waiting period ends: If your copay is 30% for a filling and the in-network rate is $100, you would pay $30 and the insurance company would pay $70 — as long as any waiting period for basic services has ended. But if you have a waiting period of 4 months for basic services and you have your cavity filled in the first 3 months, you would be responsible for the full $100.

Which dental insurance plan is right for me?

Waiting periods are one thing to consider when you’re shopping for dental insurance. You also want to look carefully at what a plan covers to see if it meets your needs.

Beyond your monthly bill, it’s also important to estimate potential out-of-pocket costs. These could include:

• Coinsurance
• Copays
• Deductible
• Maximum amounts of yearly coverage for different types of services

If you also have vision care needs, you might consider a plan that includes both dental and vision insurance. Buying them together as a combined package may be less expensive than buying them separately. Just as with dental care, preventive vision care, such as exams, may not have a waiting period and may be fully covered, depending on the plan.

And if you’re 65 or older, you may also want to buy a stand-alone dental plan, even if you’re on Medicare. That’s because you likely won’t be covered for dental, unless your doctor deems it medically necessary.

You can save by choosing an in-network dentist through one of our supplemental dental insurance plans. Learn more online, or call a licensed insurance agent at 1-844-211-7730 for more information.

For informational purposes only. This information is compiled by UnitedHealthcare and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.

Compliance code:
51805-X-1224