Main Reasons for Delayed Insurance Coverage
A common reason why consumers put off urgently needed dental care is a delay before their insurance will pay for the procedure. The three main reasons for delays in coverage are:
- The dental policy's effective date
- Attaching waiting periods to various benefits
- Deductibles
This article will educate you on the conditions delaying insurance coverage and then list examples of dental plans that lack waiting periods.
Different Types of Coverage Delays
Waiting periods are not the only condition that can delay coverage. A dental plan enrollee also must consider the plan’s effective date, deductible, and maximum benefit.
Effective Date
The effective date is the day when a dental insurance policy begins its coverage or is “in force." In other words, you cannot use your dental insurance before the effective date. Other terms for an effective date are a "start date" for the insurance policy or its commencement date. The image below shows how this website displays the effective date for each insurance policy on a quote page. The effective date is the text in red at the bottom. It states, “Apply by the last day of the current month, effective 1st of the following month.
Effective Dates can vary by insurance company. Never apply for a dental plan until you know when the plan will become effective. If you don’t see an effective date by the plan’s name, you can look at a Plan Details page or plan brochure. On the first page of our Apply page, the effective date for a plan is displayed in the lower left corner of the page. In some cases, you might have multiple effective dates from which to choose.
Once a dental policy is effective, it will be active until the end of its term. A term is the length of time the insurance policy lasts, usually a year. A policy may be renewed or discontinued at the end of its term. Some enrollees may choose to end a policy earlier than the end of its term. A policy will also discontinue if an enrollee fails to pay his or her monthly premium obligations.
Deductible
A deductible is not a waiting period but it does have an effect on when a dental plan begins to pay for care. A deductible is the amount an enrollee must pay out-of-pocket for covered care before the insurance plan will begin contributing to costs. Usually dental plans have low deductibles around $50 per person per year (although some charge more). After the deductible contributions by the enrollee are met, the plan discontinues its delay in sharing the costs of covered care.
There are three points that should be remembered about deductibles. First, not all dental plans have a deductible. Second, dental plan deductibles are often small. Third, even dental plans with deductibles may exclude some categories of care from the deductible requirement. For example, preventive care such as annual check-ups and teeth cleaning may not be subject to a deductible.
Maximum Benefit
Most dental plans have a maximum benefit, which is a limit on how much the insurance plan will pay toward covered care each year (or insurance coverage term). If a maximum benefit is reached, the enrollee will be delayed until the following year for the insurance contributions to covered care to restart.
Waiting Periods
A waiting period is the amount of time a consumer must be continuously enrolled in a dental plan before that plan will cover a specific benefit. Waiting periods are normally attached to specific services so a plan might have no waiting period for basic care such as fillings and x-rays but have a waiting period for crowns, root canals, and teeth whitening. For more detailed information, refer to our article “dental insurance waiting period.”
A dental plan with a waiting period for orthodontic benefits may still be classified as a dental plan without waiting periods because orthodontic benefits are not generally considered core dental benefits. In fact, most individual dental insurance plans do not cover braces and other orthodontic care.
Immediate Coverage Dental Insurance
Dental plans without waiting periods for preventive, basic, and major dental care are sometimes labeled “dental insurance immediate.” This label can be a bit misleading because dental plans without waiting periods still have effective dates (see discussion above). For more information, immediate coverage dental plans, see our article “Dental Insurance Immediate Coverage.”
There is an additional option for a person needing immediate dental care: Dental discount programs. These programs become active quickly after enrollment, sometimes in as little as one day. These plans also have no waiting period on covered services. Dental discount programs plans may go by other names that include Dental Savings Plans and Dental Discount Cards.
What is the Best Dental Insurance with No Waiting Period?
The below list includes dental plans in each state (and Washington D.C.) that do not have waiting periods for preventive, basic, and major dental care. Be certain to click the “Details” section on a product’s plan information page to make certain there have not been any plan updates that have changed their no waiting period status. You can also get price quotes for your age and zip code in a few clicks.
NOTE - Some of the below plans may not be available in all regions of the state for which it is listed.