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Dean George is the Marketing Specialist and Content Creator for Dental Insurance
Store and its social media channels. He is a regular contributor to Agent Straight Talk, the
only consumer blog explaining the ins, outs and in-betweens of dental insurance and
discount dental plans. READ MORE

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The Waiting Period Waiting Game

Jun 17, 2014

By Dean George

We live in an age of instant gratification. Instant meals, instant movie downloads and instant financing to buy things we saw an instant ago on a Pinterest board wish list. In almost every instance the idea of waiting for anything creates instant unhappiness.

With that being said, I promise you won’t have to wait any longer on learning why some dental plans have waiting periods. That’s right - your wait is over!

As you may recall from previous posts on this topic, Preferred Provider Organization (PPOs) dental plans have waiting periods ranging from 6 months on basic procedures to 12 months on major procedures. However, most preventive and diagnostic procedures in PPO plans do not have waiting periods. Neither Health Maintenance (HMOs) or discount dental plans require any waiting periods.

So why do some PPO plans require waiting periods? They require waiting periods for one main reason: it’s a safeguard to ensure that people don’t pay one or two months of $30 premiums, get an $800 crown and then head for the hills.

Unfortunately, if enough people abuse dental plans, plan carriers would be forced to pass on the added costs to their plan members. It doesn’t take a Mensa candidate to see how that’s a lose-lose proposition because carriers would increase their premiums, making them less competitive with other plans and more expensive for plan members.

However, there is a consumer advantage to a waiting period. Okay, I can hear your tongues clucking, see your heads shaking and imagine the skeptical looks after reading the previous sentence. But I’m serious. Here goes: since waiting periods generally apply to the more expensive procedures, this provides extra time to budget for your share of the coinsurance outlined in your plan.

I don’t know about you, but if I have a potential expense of $500 to $1,000, I’d appreciate knowing about it ahead of time! If we know in advance that we may lose a tooth if we don’t have a procedure done, most of us will budget during the required waiting period rather than trying to wish for the money with a lottery ticket or diving between the couch cushions for spare change.

An important caveat to waiting periods is that they only apply one-time as long as you have the same plan. In other words, whether you have a plan for 2 years or 10, unless your dental plan changes, you will never have another waiting period.

One final word on waiting periods. While HMO’s and discount dental plans don’t have them, PPOs do offer a perk that the other two don’t: PPOs allow you to keep your same dentist whether or not they participate in a network.  You may pay a bit more for using an out-of-network dentist, but the plan will still share in the cost of any covered procedure.

HMOs won’t pay toward any procedure when using an out-of-network dentist, and discount dental plans also require their members to use a participating provider.

One important consideration for those favoring PPOs but who dislike the idea of waiting periods: it is possible to have your PPO cake and beat the waiting period too by using a discount dental plan to bridge the required waiting periods.

As Felicia shared in January, using a discount dental plan is like paying rent month-to-month. Or put another way, it’s like buying dental treatment and paying for it in installments. You can use the dental discount plan as supplemental coverage while waiting for the end of the waiting period.  It certainly makes waiting easier if you know you’re not in it alone!

Thanks for reading Agent Straight-Talk, and if you hurry, there’s no waiting if you want to follow us on FacebookTwitterPinterestGoogle+ and LinkedIn.

Copyright 2014, Bloom Insurance Agency, LLC

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