Waiting Period

A waiting period is the amount of time you must be covered under a plan before certain benefits become available. Insurers use waiting periods to prevent individuals from joining a plan solely to claim an expensive procedure immediately. Waiting periods vary by benefit type and plan.

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For example, preventive dental coverage might begin immediately, while restorative or orthodontic coverage might have a 12- to 24-month waiting period. Health benefits such as major medical equipment may also have a delay before eligibility begins. Knowing your waiting periods helps you plan expenses and understand when new coverage starts to pay.

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Example:

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If your plan specifies a one-year waiting period for major dental services, coverage for crowns or bridges begins 12 months after your start date.

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What to Watch For:

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Verify if the waiting period is waived when switching from group to individual coverage through a guaranteed issue option. Always keep track of your plan’s effective date to calculate when benefits activate.