New York State Department Of Health, NY State Of Health, Department Of Financial Services Announce Improvements To Stand-Alone Dental Plans Offered Through NY State Of Health


From January 1, 2025, there will no longer be a waiting period for most adult dental services provided through the marketplace

New York State continues to explore improvements to adult dental benefits for 2026 and beyond

The New York State Department of Health, the New York State Department of Health, and the Department of Financial Services announced today that effective January 1, 2025, most adult dental services in individual independent dental plans will no longer have a waiting period to be purchased on the marketplace. This change is the first of a multi-phase initiative to improve dental products and improve the consumer dental plan shopping experience.

Adrienne Harris, Director of the New York State Department of Financial Services, said“New Yorkers should have ready access to essential services, and eliminating waiting periods will allow patients to get the critical dental care they need, when they need it. In line with our mission, the Department will continue to build an equitable and transparent health care system in New York.”

“Access to quality oral care is critical to overall health, so it’s critical that we help consumers get care as quickly as possible by eliminating waiting periods.” State Health Commissioner Dr. James McDonald said. “This change will make it easier and more streamlined for New Yorkers to access most dental products through the marketplace, ultimately improving their health and quality of life.”

Danielle Holahan, Executive Director of the New York State Department of Health said“Eliminating the waiting period for most dental services is the first step in our initiative to increase the accessibility and quality of dental insurance through the marketplace to better meet the health needs of all New Yorkers and further reduce the cost of dental coverage in the state’s system Sexual health inequalities.

The waiting period for a standalone dental plan is the length of time an individual must remain enrolled in the plan to receive certain services. While this change will eliminate the waiting period for most Marketplace dental plans, the waiting period for orthodontic services remains in effect, but is capped at 12 months.

The New York State Department of Health and the Department of Financial Services are working with stakeholders to collect feedback and review options to enhance access to dental care through the New York State Department of Health Marketplace. The department plans to develop standard dental plans to further enhance the quality of affordable options for consumers. Eliminating the waiting period was selected as the first step toward the long-term goal of improving adult dental products because it can be implemented seamlessly and quickly while providing New Yorkers with increased consumer protections. As this work continues, the New York State Department of Health will continue to work with the Department of Financial Services and stakeholders to understand and address additional issues.

Adults and families can get dental insurance through certain qualified health plans (QHPs) or through stand-alone dental plans on the individual market. While most dental-embedded QHP plans do not have a waiting period, this new requirement does not currently apply to the QHP market. In addition, all plans offered through the Marketplace offer a comprehensive benefits package, including free preventive care such as routine visits and recommended screenings, as well as doctor's visits, hospitalizations, urgent care and other critical health services.



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