What is a Dental Insurance Annual Maximum? Understanding Dental Benefits

What is a Dental Insurance Annual Maximum?

Your annual maximum sets the limit for how much your provider pays for covered dental services during a benefit period, usually a calendar year. Knowing that limit can help you make the most of your coverage. When you choose Aflac’s network dental insurance plans for individuals and families, your annual maximum benefit grows over time the longer you keep your plan.

Read on to learn more about how dental insurance works, what an annual maximum means for dental insurance, and what counts toward your annual maximum.

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Key Takeaways

An annual maximum is the total amount your dental insurance pays for covered services during a benefit period, usually a calendar year, after which you’re responsible for any additional costs.
Dental insurance plans may have low, high, or no annual maximums, with most applying to major and basic treatments but not always to preventive care like cleanings and exams.
Aflac network dental insurance plans for individuals and families offer an annual maximum benefit that increases over time the longer you keep your plan.

What does an annual maximum mean for dental insurance?

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. Dental insurance annual maximums often range from $1,000 to $2,000.¹

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 dental insurance annual maximum.

How does dental insurance work?

Dental insurance is a form of supplemental insurance that can help cover costs related to dental care. Some plans offer coverage for a wide range of treatments. Aflac network dental insurance, for instance, helps cover preventive, basic, and major services, from routine cleanings to oral surgery.

What counts toward your dental insurance 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.

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How does dental insurance with no annual maximum work?

Believe it or not, there are some dental insurance plans without annual maximums. If you apply for coverage, 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.

How to check your dental insurance annual maximum

Here are two ways you can find out what your dental insurance annual maximum is:

Check online

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.

Call your dental insurance provider

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.

What happens when you reach your annual maximum?

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 high, 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.

Choosing dental insurance with a high, low, or no annual maximum.

When deciding between a dental insurance plan with a high annual maximum, low maximum, or none at all, consider your coverage needs, unique situation, and budget. While plans with high annual maximums may be more costly than those with low or no annual maximums, they could help you save more on out-of-pocket costs, especially if you might require more extensive care.

Here's a helpful cost breakdown to get you started:

No annual maximum plans: Can be more costly than plans with an annual maximum, but may offer the most extensive coverage
High annual maximum plan: Typically offers wide coverage, costs less than plans without an annual maximum, but may tend to be more expensive than low annual maximum plans
Low annual maximum plans: Usually the most affordable plan type, but may not provide coverage for extensive dental services

Get a quote for a dental insurance plan

Dental insurance annual maximums can help policyholders save money on dental treatments each year. If you’re looking for affordable dental insurance, Aflac is a good option to consider. We offer network dental insurance plans for individuals and families with an annual maximum benefit that increases over time. Plus, waiting periods are mostly minimal for preventative care. It costs less by using in-network providers, and you have the option to get a plan with vision or hearing services.

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