What Does Floating Months Mean in Dental Insurance?

Dental insurance policies often contain confusing terminology. Terms like “floating months” can obscure how and when benefits are utilized. Understanding this concept is important for managing dental care and maximizing policy value. This article clarifies “floating months” to help policyholders better understand their dental benefits.

Understanding Floating Months

“Floating months,” or a “floating period,” refers to a waiting period in a dental insurance policy not tied to a standard calendar or fixed policy year. This period “floats” based on the last date a specific dental service was performed for a particular procedure type. The waiting period resets from the date of the previous service, rather than on a predetermined annual date. For example, a 12-month floating period for a procedure means eligibility for coverage begins 12 months after its last performance.

Insurance companies implement floating months to manage financial risk and maintain affordable premiums. This structure helps prevent individuals from purchasing a policy, immediately undergoing costly procedures, and then canceling coverage. By requiring a waiting period tied to the last service date, insurers aim to ensure policyholders maintain coverage longer, contributing to the insurance pool’s stability. These waiting periods typically apply to more expensive treatments rather than routine preventive care.

Impact on Dental Insurance Benefits

The concept of “floating months” directly influences when a policyholder can receive coverage for specific dental procedures. Unlike a traditional benefit year that resets annually, a floating period means eligibility for a service depends on the last time that exact service was rendered. For instance, if a dental insurance policy has a 12-month floating period for major restorative work, such as a crown, and a patient had a crown placed in January 2023, they would not be eligible for coverage for another until January 2024.

This mechanism ensures that the waiting period for certain procedures, especially more costly ones like oral surgery, root canals, dentures, or bridges, is specific to the individual’s treatment history. The waiting period begins from the date the prior procedure was completed for that specific benefit type. For example, if a policy states coverage for a deep cleaning every 36 floating months, a patient must wait three years from their last deep cleaning before insurance covers another. This approach contrasts with typical preventive care, like routine cleanings and X-rays, which often have no waiting period.

Navigating Policies with Floating Months

Policyholders can determine if their dental insurance plan includes floating months by reviewing policy documents or contacting their insurance provider. The policy terms outline specific waiting periods for different service categories, such as basic or major care, and whether these periods are fixed or floating. Understanding these terms before significant dental work is needed is important to avoid unexpected out-of-pocket costs. Many dental practices can also assist by submitting a pre-determination to the insurance carrier, which provides an estimate of coverage for planned care.

If a necessary procedure falls within a floating period, policyholders have several options. They can discuss timing with their dentist to see if treatment can be safely delayed until the waiting period expires. Alternatively, they may need to prepare for potential out-of-pocket expenses if the procedure cannot wait. Some insurance companies may offer waivers for waiting periods, especially if there has been continuous dental coverage from a previous plan without a break. Always confirm coverage details with the insurer before proceeding with any treatment subject to a floating month clause.