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Does Aetna Dental Insurance have a Waiting Period?

Dental insurance is supposed to provide peace of mind. But will it be there when you need it? Most Aetna dental insurance policies (and most policies in general) have waiting periods before different levels of coverage will begin. Just because you have dental insurance doesn’t necessarily mean any care you need today is covered.

Here’s a closer look Aetna dental insurance waiting periods, how they might affect your coverage and what options are available if you need help fast:

What is a Dental Insurance Waiting Period?

When you buy auto insurance, your coverage starts immediately after making your first payment. Health insurance usually works the same way. But dental insurance is different.

Not all dental insurance coverage begins at the same time. Instead, you’ll need to own the policy for months or even a year before certain procedures will be paid for. Simpler, preventative measures are covered earlier than complicated, more invasive care.

What Does Dental Insurance Cover?

Aetna dental insurance doesn’t cover all care equally. Generally, policies favor preventative care over restorative. Preventative care includes check-ups, x-rays, and cleanings – and, depending on the plan – potentially sealants and other cavity-prevention treatments for children.

Both their Dental Maintenance Organization and Preferred Provider plans cover 100% of preventative care. The DMO plan only covers preventative care while the PPO covers additional restorative procedures and out-of-network dental care up to $1,500. Finally, their Indemnity plan lets you visit any dentist at any time. It’s the most flexible plan but also the most expensive.

What Procedures Have Waiting Periods?

Waiting periods differ by policy and provider. DMO plans typically do not have waiting periods, PPO plans do,

Generally, preventative care is available right away. Once you make your first monthly payment to Aetna, you’ll be covered for cleanings, check-ups and other treatments designed to prevent issues from occurring.

However, waiting periods start to apply for what are called Basic procedures. These are procedures such as fillings, deep cleanings and other relatively basic, common treatments. You’ll have to own your PPO policy for six months before many basic procedures start to be covered. Insurance companies typically cover 80% of basic procedure costs.

Waiting periods often grow longer for Major procedures. These are more complicated procedures such as crowns, bridges, root canals and dental surgeries. Major procedures can have waiting periods of a year or more. Insurance covers 50% of Major procedures.

Why Do Waiting Periods Exist?

Dental problems can’t heal on their own; they only grow worse over time. The earlier treatment can begin, the more effective it’ll be. Don’t dental insurance companies understand waiting periods actually limit care options?

Unfortunately, waiting periods are a necessary aspect of dental insurance. Otherwise, people could sign up for insurance, make a single payment, max out their benefits on a procedure and then cancel their plan before the second payment is due. If enough people did this, the dental insurance industry wouldn’t survive. So, even though waiting periods can seem punitive to customers, they’re actually the only way dental insurance can exist.

What Other Restrictions Does Dental Insurance have?

Aside from waiting periods, dental insurance policies often limit coverage for pre-existing conditions. For example, most policies have a “missing tooth clause” which prohibits coverage treatment for any teeth which were missing before you purchased the plan. Dentures, bridges, implants and many other services are likely not covered for teeth you lost prior to purchasing the policy.

However, some dental work which normally isn’t covered can be if it falls under an “Extension of Benefits” provision. Some dental procedures require several sessions to complete. If a procedure was started while you had one dental policy, but you then purchased a new policy before the procedure was finished, your new company might have to cover the rest of the work.

Common, multi-stage procedures Aetna covers under the extension of benefits provision include:

  • Crowns and fixed bridgework
  • Dentures
  • Root canal

Is Dental Insurance the Best Way to Save on Dental Care?

Not always. Dental insurance is a great option if you only need preventative care. Plus, if provided by an employer, dental insurance can be very affordable.

However, waiting periods can restrict treatment for dental problems you have today. In those cases, dental discount plans are often the better option. Never heard of a dental discount plan, also called a dental savings plan?

Joining a dental discount plan costs about $10 to $15 a month. Members receive fast access (within 72 hours after joining) to big-time savings. Specifics vary based on plan type, but you can save between 15% and 50% on preventative, basic, major and cosmetic procedures. Over 241,000 dentists are available to see nationwide within the Aetna discount plan network.

Plus, Aetna Dental Plans have no waiting periods. Discounts are available about 72 hours after you become a member. You can use the discounts as often as you like, with no annual limits or limits on treatments for existing dental problems.

Do you have an existing dental issue, such as gum disease or a cavity? Begin treatment as soon as possible to reduce the risk of additional damage. If dental insurance waiting periods are slowing your efforts to save, an Aetna dental discount plan can help you afford the care you need right away. 


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