Effie Date couldn’t take it anymore; unwittingly she felt she was at her wit’s end.
She had done everything she could to explain why dental plans became effective when they do, yet she often found herself misunderstood and unappreciated. At a co-workers suggestion, she scheduled an appointment with her company’s psychologist, Dr. Frenotomy.
“Effie Date to see Dr. Frenotomy,” she told the receptionist the morning of her appointment. Three minutes later she was ushered into the psychologist’s office. There, she quickly noted a bust of Sigmund Freud, an autographed picture of famed Seattle psychologist, Frazier Crane and an oak desk, half the size of Rhode Island.
“Ms. Date, I’m Franklin Frenotomy,” he said warmly while rising from his leather desk chair to greet her.
“Please, call me Effie,” she said shaking his hand and returning his smile.
After the formalities of offering her a beverage and a minute of small talk, the two got down to business.
“Let me be frank. I requested this appointment because I feel like I’m at a professional crossroads,” she said dramatically. When Dr. Frenotomy said nothing, she continued. “You see, my job is to help dental plan members with the use of their plan. I help get their plan started so they can get the dental treatment they need.”
Dr. Frenotomy slowly nodded, encouraging her to continue. “I love my job and enjoy helping people, but the problem is many people don’t understand what exactly I do.”
“And that is…?” Dr. Frenotomy gently encouraged, cocking an eyebrow.
“Each month, I assist hundreds of people in the beginning phases of their dental plans, whether they are HMO, PPO or discount plans.”
“Helping people as you do sounds rewarding,” Dr. Frenotomy said with a small smile.
“Oh, it really is,” Effie said happily. “I love assisting individuals with their dental plans and I pride myself on helping those around me while assisting with their dental needs. The problem is, many people seem confused on what a waiting period is. When I try to explain the difference between a waiting period and what it is I do, they – they…” Her voice trailed off and she stifled a sob.
Dr. Frenotomy sat there passively, mentally processing what she was saying, but as stoic and immobile as the Freud bust a few feet away. For some reason, he unconsciously began thinking of his mother and felt guilty he hadn’t called her in awhile.
“Please, go on,” he said gently.
Effie proceeded, “They accuse me of lying to them! They say I’m talking out of both ends of my mouth.”
What an interesting figure of speech, he thought to himself. “Why do you think they say that?” Dr. Frenotomy asked, perplexed. “Nothing you’ve told them would warrant them saying such a thing.”
“I don’t know! I explain that their dental plan has no waiting periods for procedures, but when I tell them the plan doesn’t start until the first of next month, it confuses them,” Effie said while wiping away a tear.
“Please go on?” the doctor said quietly, suddenly fighting an urge to chew on his expensive pen.
“They’ll say things like, ‘I thought you said this plan didn’t have a waiting period, but now you’re telling me I have to wait until next month to begin using it.’”
“What else do they say?” the doctor asked.
“They’ll say something like, ‘So, there are two waiting periods - one for the plan to begin and one where it will pay for the treatment I need,’” she said in a tone that reminded him of his mother nagging him as a junior high student about his homework.
“Only if you have a PPO plan, I tell them. Our PPO plans have a six-month waiting period for basic procedures and a 12-month waiting period for major procedures, but HMO plans and discount dental plans have no such waiting periods.”
“Still, I can’t use the plan until next month, right? I respond by saying, ‘that’s right, but the time between when you enroll and when your plan begins isn’t called a waiting period. That’s what I do and it’s called an effective date.’”
“What do they say after that?” the doctor asked, intrigued.
“They say that waiting for a plan to begin or waiting to use a plan’s benefits is still a waiting period.”
“How does that make you feel?” Dr. Frenotomy asked impassively.
“Well, the President did say a few years ago that insurance was complicated, didn’t he? I guess I just need to be patient, do my best to educate people on the difference between waiting periods and effective dates and continue helping those looking for quality dental plans,” she said brightly. “Thank you, doctor. It has really been helpful to talk about this.”
Smiling politely, Dr.Frenotomy stood, shook Effie Date’s hand and walked her to the door. After she left he asked his receptionist, “Who do I have at 11 o’clock?”
“Mr. Wayton Pireed,” she replied.
As previously written in this space, there’s no question insurance terms can be confusing. Two of the most commonly misunderstood terms are waiting periods and effective dates.
There isn’t much we can do about confusing insurance vocabulary other than to answer questions about them and offer a comprehensive glossary to visitors. With that being said, there’s a lot we can do to make your dental plan shopping experience easier and successful. To see plans available in your area, click here and enter your age and zip code.
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