Dental benefit maximum calculator: how much will the plan pay and how much will you owe?
Most dental plans stop paying once you reach an annual maximum. This calculator shows how the deductible, coinsurance and annual maximum work together on a single procedure.
Estimate what the plan pays and what you owe
Use the numbers from your dental plan summary and your dentist estimate.
From your dentist estimate.
Often 50 percent for major work. Check the category for your procedure.
Your estimate
This calculator gives an estimate only. Waiting periods, frequency limits, network discounts and procedure categories vary by plan. Ask your dentist for a pre-treatment estimate.
How the annual maximum works
A dental plan pays a share of covered costs until it reaches a yearly cap. After the cap, you pay the full cost of care. Because the cap is often a modest figure, a single crown or implant can use most of it, and a second large procedure in the same plan year can fall almost entirely on you.
Planning around the maximum
If you need more than one major procedure, spreading them across two plan years can let you use two annual maximums. Ask your dentist for a pre-treatment estimate and check whether the plan has waiting periods for major work before you schedule it.
Common questions
Does the annual maximum reset every year?
Usually at the start of the plan year, which may not be January. Check your plan.
Do preventive visits count against the maximum?
Many plans cover preventive care outside the maximum or at a higher share. Check your plan summary.
What is a waiting period?
A period after enrollment before certain services are covered. It is common for major work.
Why do dentists give a pre-treatment estimate?
It shows what the plan expects to pay so you can plan before treatment begins.
Talk to us about dental coverage
Book a 30-minute call and we will look at your group, your budget and the dental options that fit. Visit us at 41000 Woodward Avenue, Suite 350 East, Bloomfield Hills, MI 48304, or call 248.370.8853.
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