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subject: Dental Insurance Coverage Types and Waiting Periods [print this page]


Dental Insurance Coverage Types and Waiting Periods

Once they decide that buying a dental insurance most patients rush into contracting an insurance company without carefully analyzing the market. This is why most of these people end up unsatisfied with the insurance service they paid for.

Major dental insurance coverage categories

Although differences between dental insurance companies' services are rather small, these details can make a big difference in raising or lowering the satisfaction degree of the beneficiary. Most dental insurance companies delimitate dental procedures into three general categories:

a)Prevention

Routine cleaning, regular visits to the dentist and examinations are considered to be a part of the preventative dental care. In some cases, sealants, x-rays and fluoride is also included in the prevention treatment coverage, but depending on the dental insurance company's policy, these procedures can also be placed in the second major category

b)Basic Care or Restorative Treatment

Simple extractions or filling are the most common basic or restorative operations covered by dental insurance. Some companies list root canals on the third category, but most of them list root canals as basic interventions.

c)Major procedures

Dentures, bridges, crowns, dental implants, partials or surgical extractions are all a part of the major procedures that need coverage.

These categories are vague and extremely general, therefore each dental insurance company has the right to place various dental procedures in which category they like in order to offer coverage accordingly. Before buying dental insurance, patients have to make sure that all covered procedures are clearly placed on these categories in order to know what to expect from their coverage. Some insurance companies do not cover major procedures at all, while others establish waiting periods for some major and basic interventions.

Besides the waiting period, there is an additional clause to the contract that refers to "the missing tooth". This means that the insurance company does not cover expenses for replacing teeth that were already missing before the dental insurance contract came into vigor.

On the waiting list

A dental insurance waiting period refers to the necessary time the insurance company communicates to its clients that they have to wait in order to get paid for certain insurance covered procedures. These are totally variable periods from one insurance company to another and can also vary according to each dental insurance company's strategy of returning the money for covered procedures.




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