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Understanding Dental Insurance Annual Maximums

What is a maximum? There are two types of maximums — annual and lifetime.

An annual maximum is the most money a dental plan pays for dental care for you or your family (under a family plan) within a 12-month benefit period. Once you reach the maximum amount, you’ll be responsible for paying any costs for the remainder of the benefit period.

lifetime maximum is the most money a dental plan pays for dental care for an enrollee or a family (under a family plan) for the life of the enrollee or family or the life of the plan. Lifetime maximums usually apply to specific services, such as orthodontic treatment (braces).

How can I check my plan maximum(s)?

There are three ways to check how much remains before reaching any plan maximum(s).

· Log in to your online account. 

· Ask your dental office for your plan’s annual and lifetime maximum information.

What you should know if you have a maximum

· Your dental plan could be based on a calendar year (January through December) or a contract year (starts and ends during a different 12-month period). Once you reach the annual maximum, you’re responsible for all costs for the remainder of the plan year.

· Depending on your dental plan, some services might not count toward your maximum, such as diagnostic and preventive services. 

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance.

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2024