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Dean George is the Marketing Specialist and Content Creator for Dental Insurance
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only consumer blog explaining the ins, outs and in-betweens of dental insurance and
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The Importance of Waiting – Effective Dates & Waiting Periods

Jan 14, 2014

By Felicia Papier

As a society, we are pretty impatient.  I know I am when it comes to most things.  I cannot wait to use something or complete something or have that new shiny something arrive at my house.  Let’s face it – we want it and we want it NOW!  (Yes, we basically sound like a bunch of whiny two-year olds.)

Unfortunately, the world forces us to be patient, which honestly isn’t so bad.  Dental insurance plans are no different and make us wait as well.  There are effective dates and waiting periods which both can be hard to understand.  Why do you have to wait?  I would love to give you the reason I give my six- year old on most days… “Just because.”  But there are actual reasons and I will help explain both of these confusing terms today. 

So what is the difference between effective dates and waiting periods?  They are easily confused so here are the definitions of both:

Effective date (noun) – the date you are officially covered by your dental plan.  Used in a sentence: “Julia’s new dental plan has an effective date of March 1st and her insurance will cover most of her procedures at the dentist starting that day.”

Waiting period (noun) – a period of time in which the insurance company will not pay for certain procedures.  Used in a sentence:  “Julia’s dental crown won’t be covered by her insurance yet because there is a six month waiting period for that procedure even though her effective date was in March.”

Let’s chat about effective dates first.  Here is some food for thought:

-          Tip: buy early, use sooner.  For most of the traditional dental plans at Dental Insurance Store, if you purchase them before the 25th of the month, your plan is effective on the first of the following month.  If you enroll after that date, your plan goes into effect the month after.

-          Tip: plan dental visits accordingly. If you purchase a dental plan that goes into effect on February 1st, you don’t want to schedule a trip to the dentist on January 21st.  You won’t be insured yet!

-          Tip: plan your insurance purchase accordingly.  If you have a dental emergency and are not insured, you’ll want something with an immediate effective date so you can get into the dentist quickly.

Most traditional dental insurance plans start their coverage on the first of every month.  But there are policies that have next day effective dates.  These are discount dental plans which work like a coupon at the dentist office.  The dentist still needs to accept these policies, so it’s not quite like going to Bed, Bath and Beyond® and handing them stacks of $5-off coupons that you have in your wallet.  Discount dental plans generally give up to 25% off the dentist’s usual and customary fee on services.  If you have a dental emergency, this is the way to go.  Saving 25% is much better than paying full price or even worse… just not going at all. 

Discount plans are also great as supplemental plans.  Let’s say you bought a traditional dental plan from Dental Insurance Store and the effective date is April 1st and there is a waiting period on the plan for a root canal of 6 months.  Wow – that is A LONG time to wait since it’s only January.  Discount plan to the rescue!  A discount plan is like paying rent for an apartment month-to-month.  Use it up until your effective date occurs for your traditional plan and continue usage as a supplement while you are waiting for the waiting period to end!

Speaking of waiting periods again, even though they sound really pesky, they have a purpose.  And it’s not just to make you wait for the sake of waiting!  That is what the dentist’s waiting room is for… A waiting period protects both the insurance carrier as well as the patient. 

Dean gave a great scenario last year about waiting periods, “The purpose of a waiting period is it prevents people from dropping coverage immediately after having an expensive procedure done.  For example, if your monthly premium is $30 and you’ve paid only two months’ premiums and then obtain $600 worth of dental treatment, the insurance company is going to have less money to pay for other members’ oral care, including members that may have been paying their premiums for several years.

That would drive up everyone’s coverage costs and since we’re all in this together, what’s the advantage to that?”

Most of the time, the more complicated and expensive procedures like root canals and crowns are those with a waiting period.  Another benefit waiting is it gives you time to plan financially for an expensive procedure.  Also, once you have waited out your waiting period, you never have to do it again.  It’s like earning a scout badge… it’s yours and you’ll be able to have major procedures anytime you want!

We know that insurance terms can be overwhelming, so we hope we helped you out a bit.  Make sure to read Dean’s article last week about Deducing Dental Deductibles and come back for more jargon lessons next week.  Thanks for reading and remember, you are never fully dressed without a smile!

Copyright 2014, Bloom Insurance Agency, LLC©

Photo credit: beanandnash

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