An annual maximum is the most a dental insurance plan will pay toward covered care in a benefit year, which is typically a 12-month period. Once that limit is reached, the member usually pays additional covered dental costs out of pocket until the next benefit period begins.
Typical annual maximums often vary depending on the plan benefits. This matters because one major procedure or a combination of treatments can use up the plan’s yearly benefit faster than many people expect.
This topic matters especially when comparing PPO options because annual maximums are common in that plan type.
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You usually pay additional costs yourself until the plan year resets.
No. Dental plans usually cap what the plan pays, not what the member pays.
No. Many HMOs typically do not use that structure. Although their coverage and benefits tend tends to be much lower compared to PPO plans.
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