An annual maximum is the limit your dental insurance plan will pay for certain costs each year. If you’re shopping for a dental plan, or have 1 already, it’s important to know your annual maximum to help avoid surprise out-of-pocket costs.

Here are some more details about dental insurance annual maximums.

How does an annual maximum work?

Let’s say your annual maximum is $1,000. That means all of the qualifying dental care you receive in a year up to $1,000 will be paid by your dental insurance. All charges after $1,000 must be paid by you.

For example:

Annual maximum remaining

Start of year

 

$1,000

Dental service 1

$300

$700

Dental service 2

$400

$300

Dental service 3

$300

$0

Dental service 4

$250

You pay out of pocket

Once a new year starts, your annual maximum will reset.

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What dental services count toward the annual maximum?

Most dental plans offer unique coverage. However, many plans don’t count preventive and diagnostic treatments like cleanings, exams and routine X-rays toward the annual maximum.

Some dental services that may count toward an annual maximum include:

How can I check my annual maximum?

You have a couple of ways to check your annual maximum:

  1. Call your dental insurance company and ask them directly. Be sure to have your policy number ready before you call.
  2. If you have an online profile with your insurance provider, sign in to your account. You should be able to find your annual maximum in your plan details. If you have a dental plan with Humana, you can find your annual maximum by signing in to your MyHumana account.

Frequently asked questions

An annual maximum is the limit your dental insurance will pay toward the cost of dental treatment in a plan year. A deductible is the amount you pay toward certain expenses before your insurance kicks in.

A lifetime maximum is the total amount of money insurance will cover for orthodontic treatments over a lifetime. Unlike annual maximums, lifetime maximums don’t reset each year. Once you reach the maximum, you pay all future costs for as long as you keep the plan.

Learn more about dental insurance

At Humana, we understand you may have more questions about dental insurance. To learn about dental plans, dental care and dental procedures, check out our library of dental articles.

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