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A dental insurance annual maximum is the maximum dollar amount your plan will pay toward the cost of dental services within a specific period, usually a calendar year. If you have dental insurance or want to get a plan, it’s important to understand your annual maximum so you can make the most of your benefits. Read on to learn more about how dental insurance annual maximums work.
Many dental insurance plans come with an annual maximum. This is the money that the insurance company offers. It will go toward qualifying dental treatments you receive over a benefit period, which is typically 12 months.1
If your annual maximum is $1,000, for example, your dental insurance plan will pay its portion of the bill up to $1,000 within that year. Once the new year starts, your annual maximum will reset, and a new benefits period will start. Ideally, you’d schedule any treatments you need before the end of the year so you can get the most out of your annual maximum.
While every dental plan is different, many plans may not count preventative and diagnostic treatments, like cleanings, exams, and routine X-rays, toward the annual maximum. Most dental plans cover routine care.
You should reach out to your dental insurance company to figure out what does and doesn’t count toward your maximum.
Believe it or not, there are some dental insurance plans without annual maximums. If you sign up for one, there won’t be any limit on what the insurance company will cover.2 They’ll pay out for all qualifying procedures that are listed in your policy. Keep in mind that this type of plan is usually more expensive than plans with annual maximums.
Here are two ways you can find out what your annual maximum is:
Log into your dental insurance company’s website with your username and password. Once you do, you should be able to find all the details of your plan in your online dashboard, including your annual maximum.
You can call your dental insurance company directly and ask them about your annual maximum. Be prepared to prove your identity and state your policy number.
Once you reach your annual maximum, you must pay for 100% of the cost of the dental treatments you receive in that benefit period.3 While your annual maximum might seem like a lot of money, understand that dental costs can add up quickly. Therefore, it’s important to plan accordingly so you can make the most out of your benefits.
If you’re looking for affordable dental insurance, Aflac is a good option to consider. We offer dental insurance plans with an annual maximum benefit that increases over time. Plus, waiting periods are mostly minimal for preventative care. It's less money by using in-network providers, and have the option to get a plan with vision or hearing services. For more information, start chatting with an agent and get a quote today!
1 Investopedia - How Does Dental Insurance Work? Updated March 9, 2022. https://www.investopedia.com/articles/personal-finance/111715/how-does-dental-insurance-work.asp. Accessed April 25, 2023.
2 Investopedia – Best Dental Insurance Plans with No Annual Maximum. Updated June 30, 2022. https://www.investopedia.com/best-dental-insurance-plans-with-no-annual-maximum-5192783. Accessed April 25, 2023.
3 Investopedia – Should I Buy Dental Insurance? Updated March 7, 2022. https://www.investopedia.com/articles/pf/07/dental-insurance.asp. Accessed April 25, 2023.
Coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, coverage is underwritten by American Family Life Assurance Company of New York.
Dental (81000 series)
In Arkansas, Policies A81100AR–A81400AR. In Delaware, Policies A81100–A81400. In Idaho, Policies A81100ID–A81400ID. In New York, Policies NY81100–NY81400.In Oklahoma, Policies A81100OK–A81400OK.In Oregon, Policies A81100OR–A81400OR.In Pennsylvania, Policies A81100PA–A81400PA.In Texas, Policies A81100TX–A81400TX.In Virginia, Policies A81100VA–A81200VA.
Dental (82000 series)
In Arkansas, Policies A82100RAR–A82400RAR. In Delaware, Policies A82100R–A82400R. In Idaho, Policies A82100RID–A82400RID. In New York, Policies NY82100–NY82400. In Oklahoma, Policies A82100ROK–A82400ROK. In Oregon, Policies A82100ROR–A82400ROR. In Pennsylvania, Policies A82100RPA–A82400RPAR. In Texas, Policies A82100RTX–A82400RTX. In Virginia, Policies A82100RVA–A82400RVA.
Coverage is underwritten by Tier One Insurance Company.
Dental, Vision, Hearing (DVH): Policy Series T80000 - In Arkansas, Policy T80000AR. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. In Oregon, Policy T80000OR. In Texas, Policy T80000TX.
This is a brief product overview only. Coverage may not be available in all states, including but not limited to DE, ID, NJ, NM, NY or VA. Benefits/premium rates may vary based on state and plan levels. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policy and rider forms for benefit details, definitions, limitations and exclusions. For complete details, including availability and costs, please contact your local Aflac agent.
Content within this article is for informational purposes only and does not constitute legal, tax, accounting or medical advice regarding any specific situation. Aflac cannot anticipate all the facts that a particular employer will have to consider in their benefits decision-making process. This article contains a general overview and is not intended to portray any specific benefits or details of Aflac policies.
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