A dental insurance provision may limit or deny coverage for the replacement of teeth that were lost prior to the effective date of the policy. For instance, if an individual purchases a dental plan and already has a gap from a prior extraction, the plan might not contribute towards the cost of a bridge, implant, or denture to fill that specific space. This stipulation is common in many dental insurance agreements.
This type of clause serves as a cost-control measure for insurance providers. It helps to prevent individuals from purchasing dental insurance solely for the purpose of covering pre-existing conditions, which would substantially increase the financial burden on the insurer. Historically, the inclusion of such clauses has helped to maintain lower premium costs for all policyholders by mitigating the risk of covering expensive, long-standing dental issues immediately upon enrollment.