Employee Benefits
What Is a Waiting Period in Insurance?
A waiting period is the time between when you sign up for insurance coverage and when it goes into effect. It can also refer to the period between starting a new job and gaining access to your employer-sponsored benefits, like health and dental insurance. While in a waiting period, you won’t be able to use some or all of your benefits—so it’s important to know how long it’ll last. When applying for insurance coverage, be sure to look through the waiting periods required by each provider to find the best option for you and your health.
How do insurance waiting periods work?
Waiting periods usually depend on your insurance carrier. Some insurers require a waiting period on the entire policy, while some might only have a waiting period that applies to specific parts. You’ll want to clarify how waiting periods affect your policy before you buy it.
For example, say you sign up for a dental insurance plan with a waiting period. You may be able to go to the dentist for routine care, but not for more complex procedures, like crowns or implants. Those benefits won’t be available to you until the waiting period is over.
Similarly, if your workplace utilizes waiting periods for employee benefits access, you may not be able to sign up for some or all of your benefits until a later date.
Below are a few examples of waiting periods for certain insurances.
How long are insurance waiting periods?
The length of your waiting period depends on the type of insurance you choose and the insurance company you go through. It may also rely on the rules your workplace has regarding benefits eligibility. Waiting periods can last for one to several months.
Dental insurance waiting periods
Dental insurances typically utilize three tiers of care: preventive, basic, and major — and the waiting period differs for each. Preventive care is usually covered right away, while basic care often has a waiting period of 6 months. Major care typically must wait a full year.
Health insurance waiting periods
Often, health insurance has an initial waiting period of 30 – 90 days, with 90 days being the government-mandated limit. However, certain conditions and procedures may have waiting periods with longer time requirements before coverage kicks in. For example:
Care for cancer and cardiovascular conditions often has waiting periods of 1 – 2 years.
Maternity/pregnancy care can have waiting periods as long as 10 – 12 months, but they commonly run 30 – 90 days.
Pre-existing conditions exclusion
If you have a pre-existing condition when you enroll in health coverage, you may be subject to a pre-existing condition exclusion. This type of waiting period can last a maximum of 12 months, unless you’re a late enrollee, in which case it can go up to 18 months. It excludes coverage for any conditions that were diagnosed or recommended for treatment in the 6 months prior to your enrollment date.
If you get coverage through a health management organization (HMO) with an affiliation period, your plan can’t require a pre-existing condition exclusion. Likewise, if you can provide proof of continuous coverage prior to changing policies, that coverage can count toward your pre-existing condition exclusion period.
Pet insurance waiting period
Pet insurance, much like our own health insurance, has a similar waiting period structure. After purchasing insurance for your furry friend(s), a certain amount of time must elapse before you can start using specific coverage options.
For example, accident coverage can go into effect immediately or within a few days, whereas illness and surgery coverage usually has at least a 2-week waiting period. Additionally, pre-existing conditions may not be covered at all. Check your pet insurance company’s guidelines to be sure.