Annual maximum
Most plans cap what they pay each year between $1,000 and $2,000, a figure largely unchanged since the 1970s. Once you hit it, you pay the rest. Unused benefits usually do not roll over.
The three coverage tiers
Preventive care such as cleanings, exams, and x-rays is typically covered at 100 percent. Basic services like fillings run around 80 percent. Major services including crowns, bridges, and dentures are commonly 50 percent.
Deductibles and waiting periods
A deductible, usually $50 to $100, applies before basic and major coverage begins, and it often does not apply to preventive visits. New plans may impose six to twelve month waiting periods for major work.
Sequencing treatment across plan years
If you need several crowns, splitting them across December and January uses two annual maximums. We will map that out for you before you commit to anything.
Key takeaways
- •Use preventive benefits every year, they are effectively prepaid.
- •Annual maximums reset and do not roll over.
- •Sequencing large treatment plans across years saves real money.
This article is general information, not a diagnosis. Your situation deserves an exam.