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What is a Dental Maximum Annual Benefit?

Dental Shop Staff Writer | April 17, 2023

Deciding what dental plan is right for you can be a tough decision. There are many things to consider when selecting a plan. Things to consider are the premium, network, coverage, effective date, and the maximum annual benefit. Although all of these things are important, we will be focusing on the maximum annual benefit and how that can affect your plan selection.

Dental insurance plans are different than your typical health insurance plan. On a typical health insurance plan, you have an out-of-pocket maximum, whereas a dental insurance plan will have a maximum annual benefit. In both cases, you need to meet a deductible, although the deductibles on dental plans are much lower than on health plans.

The maximum annual benefit is the most that a dental plan will pay out for covered services in a given year. For people that need a lot of dental work done, a plan with a higher maximum annual benefit is going to be a better option than a plan with a lower maximum annual benefit. For those that need a lot of dental work done immediately, for things such as wisdom teeth removal, the Spirit Senior Preferred Network or the Primestar Dental Total plan are good options. The Spirit plan has a maximum annual benefit of $3500 and the Primestar plan has a maximum of $2000.

For those who can afford to wait for their dental work or foresee a large amount of dental work in their future, such as dental implants, a scaling maximum annual benefit plan would be a good option. A plan with a scaling maximum annual benefit will have increases in the annual maximum benefit over the next 2-3 years. A good option for people who are looking for high maximum annual benefits in the future would be the Spirit Dental Pinnacle Network plan. The Spirit Pinnacle Network plan has a scaling maximum annual benefit of $1200/$2500/$5000. This means that in year one, the maximum annual benefit is $1200, and $2500 and $5000 in years 2 and 3 respectively.

 

Category: Dental Insurance (general)
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