The Delta Dental Dental Preferred Provider Organization plan requires a waiting period before certain more expensive services will be covered. A six-month waiting period applies for implants, bridges, partial dentures, full dentures, crowns and cast restorations. A 12-month waiting period applies for initial placement of bridge or denture to replace one or more natural teeth missing prior to the member's effective date of coverage. A 12-month waiting period applies for orthodontic treatment. This discourages members from joining for one year just to receive expensive major services while only paying premiums for one year. Waiting periods cannot be appealed.
Unlike our medical insurance options, which are self-insured, our dental products are fully insured. This means that the insurance carriers, not the state, are the ones that assume the risk of premium payment versus claims cost.
The Cigna DHMO does not require any waiting periods before services will be covered. This is because the DHMO plan pays a fee each month to the participating dentists for each enrolled member and, in turn, the dentists have agreed to deep discounts in their fees.