Dental Insurance with Pre-existing Conditions?

Dental Insurance with Pre-existing Conditions?


A pre-existing condition is something that you have or were already diagnosed with prior to enrolling in your dental insurance plan. We see it often with medical coverage, which is why the Affordable Care Act was written in a specific way to protect at-risk patients. While medical insurance may have laws to make it mandatory for all conditions to be covered — pre-existing or not — dental insurance isn’t set up the same way. You can get dental insurance, even if you have a pre-existing condition, but fixing that condition may not be covered right away … or ever. 

What Pre-Existing Clauses are Included in Your Dental Insurance Policy? 

In dentistry, nearly all oral health conditions are preventable. The goal of your dental insurance is to help you prevent problems like gum disease or decay from getting to the point where your tooth is non-restorable or too expensive to fix.  As such, many dental insurance policies include pre-existing clauses that protect them against paying large sums of money for dental bills if you’ve only been enrolled for a short period of time.

One example of a pre-existing condition that may not be covered under traditional dental insurance is called the “missing tooth clause.” That means if you’re missing a tooth and you sign up for dental insurance to do something about it (such as get an implant or bridge), and your policy has a missing tooth clause -your missing tooth may not be covered. You’ll have to pay for fixing it out of your own pocket, along with paying your monthly insurance premiums.

Pay Attention to Waiting Periods 

Waiting periods are linked closely with pre-existing conditions. Maybe you enroll in a traditional Cigna Dental Insurance plan because you know that you have some broken teeth that need to be fixed. You expect to have them repaired right away, but your specific policy may state that there is a waiting period before your coverage kicks in.

While preventive services are generally covered immediately, your policy may say that you need to wait six months to even a year before treatments like crowns and root canals. Waiting periods also involve how frequently prosthetics such as dentures and crowns can be replaced…such as only every five years.

Prevention, Prevention, Prevention 

Are you holding out to get that crown, even though you needed it yesterday? There’s no way to reverse the damage that’s already there, but you can take steps to prevent decay from damaging your other teeth.

Schedule preventive care appointments with your dentist and hygienist at least twice a year. Most Cigna Dental Plans and Cigna dental discount programs include two visits per year in their coverage. During these visits, you can discuss preventive services such as bite guards for clenching, preventive fluoride treatments to strengthen your enamel, and therapeutic cleanings to halt and reverse gum disease.

If you’ve been without insurance due to waiting periods or pre-existing clauses, it’s best to not avoid your regular checkups. Otherwise, you may find yourself in a more complicated situation further down the road. 

Consider a Dental Discount Plan Option 

When your dental insurance doesn’t cover a specific type of treatment (whether you have a pre-existing condition or not) it usually means that you either don’t get the treatment or you have to pay for it out of pocket. Fortunately, there are other affordable options that can help you get a discount on procedures in the dental office.

One of those options is a discount dental plan. Discount plans can be used alone or alongside insurance when your policy doesn’t cover the treatment you need. For instance, if there’s a pre-existing missing tooth clause and you want to get an implant but your insurance won’t cover it, your Cigna discount plan gives you a set percentage off of the procedure, as long as you’re seeing a participating provider.

Learn more about how you can save on your dental care through affordable Cigna discount dental plans today. Contact the savings experts at Cigna Dental Plans for a no-pressure quote.

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