What is a Dental Insurance Annual Maximum?

Your dental insurance annual maximum is the maximum amount a dental plan may pay for covered services during a benefit period, which is often a calendar year. Understanding this limit can help you better understand how your dental benefits work and assist with planning for anticipated dental expenses.

Some Aflac network dental insurance plans include features that may increase the annual maximum benefit over time for insureds who remain enrolled in the plan, subject to policy terms and conditions. Plan features, benefits, limitations, and exclusions vary. Review your policy or certificate for complete details.

This article explains how dental insurance generally works, what an annual maximum is, and how certain covered services may apply toward an annual maximum.

5 min. read

Table of Contents

Key Takeaways

An annual maximum is the total amount your dental insurance will pay for covered services during a benefit period, after which you’re responsible for any additional costs.
With many dental insurance plans, annual maximums typically apply to basic and major treatments. Preventive care usually doesn’t count toward the limit.
Certain Aflac network dental insurance plans include an annual maximum benefit that may increase over time, subject to policy provisions. Supplemental dental insurance may help provide benefits for certain covered expenses not paid by a primary dental plan. Refer to the applicable policy for benefit details, limitations, and exclusions.

What does an annual maximum mean for dental insurance?

Many dental insurance plans include an annual maximum. This is the total amount your insurance company will pay toward covered dental services during a benefit period, which is typically 12 months. Dental insurance annual maximums often range from $1,000 to $2,000.¹

Once you reach your limit, you’re responsible for any additional costs until your plan resets. Planning treatments around this timeline can help you get the most value from your coverage.

What are dental insurance benefits?

Dental insurance helps reduce the cost of dental care. In exchange for a monthly premium, your plan may help pay for a wide range of services, including:

Preventive care: Routine exams, cleanings and X-rays
Basic services: Treatments like fillings and simple extractions
Major services: More complex procedures, such as crowns and oral surgery

Understanding how your dental insurance benefits work can help you better manage your costs throughout the year.

What counts toward your dental insurance annual maximum?

While every dental insurance plan is different, most plans only apply payments for basic and major services toward your annual maximum. These plans typically don’t count preventive and diagnostic services, such as:

Routine cleanings
Oral exams
X-rays

Since coverage details can vary, it’s important to review your plan’s details or contact your dental insurance provider to confirm what counts toward your annual maximum.

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How does dental insurance with no annual maximum work?

Some dental insurance plans have no annual maximum, which means there isn’t a cap on what the plan will pay for covered services within a benefit period. However, these plans often come with higher premiums and may still have other cost-sharing features, such as deductibles or coinsurance.

How to choose the right annual maximum amount

Dental insurance annual maximums can vary by plan, so it’s important to weigh your options carefully when choosing coverage. As you do, consider the following tradeoffs:

No annual maximum plans typically offer broader coverage but come with higher premiums.
High annual maximum plans provide more coverage for basic and major procedures but may cost more per month.
Low annual maximum plans usually have lower premiums but may limit coverage for more complex care.

How to check your dental insurance annual maximum

You can find your plan’s annual maximum by:

Checking online: Log in to your insurer’s website and review your policy details through your account dashboard.
Calling your provider: Reach out to your insurance company and ask about your current benefits and remaining

What happens when you reach your annual maximum?

Once you reach your dental insurance annual maximum, your plan will no longer pay for covered services during that benefit period. You’ll be responsible for 100% of additional costs until your benefits reset.²

Fortunately, there are still ways to manage dental care expenses after you reach your annual maximum. Some cost-saving strategies include:

Asking your dentist about payment plans: Many dental offices offer payment plans to help spread out costs for basic and major treatments.
Scheduling care strategically: Plan major procedures while you still have room in your annual maximum or spread treatments across two benefit periods when possible.
Using supplemental coverage: Supplemental dental insurance can help you cover expenses that your primary plan doesn’t cover, including costs for services that exceed your annual maximum.

Get a quote for Aflac dental insurance

Understanding your dental insurance annual maximum can help you make smarter decisions about your care and spending throughout the year.

Aflac offers network dental insurance plans with an annual maximum benefit that increases over time. These plans can help cover preventive, basic and major services. Additionally, Aflac offers supplemental dental insurance plans that may provide benefits for certain covered dental expenses, helping to make dental care more affordable.

Speak with an Aflac agent today to explore your options and find a plan that fits your needs.

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