Dental insurance annual maximum planner.

How the split is worked out

The plan pays its percentage of the price above the deductible, but never more than what is left of the annual maximum. If the treatment costs more than that, the extra is yours. When the maximum and deductible reset at the start of the next plan year, the rest of the treatment can draw on a fresh maximum. This tool sizes this year's share so the plan pays out exactly what is left of the maximum, and puts the rest in the next year, paying the next year's deductible again. An annual limit is a cap on what the plan pays in a year; a deductible is what you pay before the plan starts to pay.

Worked example. Maximum $1,500, $300 used, so $1,200.00 left. Deductible already met, plan pays 80%, treatment $3,000. All this year: the plan pays $1,200.00 and you pay $1,800.00. Split: do $1,500.00 this year (the plan pays 80% = $1,200.00, you pay $300.00), then the other $1,500.00 next year with a $50 deductible (the plan pays $1,160.00, you pay $340.00). You pay $640.00 in total, $1,160.00 less than doing it all now.

The catch. Whether treatment can safely wait is the dentist's call. Decay and gum disease do not pause for a plan year. This tool only shows the arithmetic, so talk to your dentist before delaying anything. Waiting periods and limits on particular services may also apply and are not modelled here.

Sources (each opened 2026-10-08): HealthCare.gov Glossary: Annual limit; HealthCare.gov Glossary: Deductible; HealthCare.gov Glossary: Coinsurance. The prices and percentages in the form are example inputs, not published figures.

On Canada's public plan, see the Canadian Dental Care Plan eligibility checker.

FAQ

How do I know how much of my dental annual maximum is left?

Subtract what the plan has paid so far this plan year from the annual maximum. Your insurer or the plan portal shows the amount used. Enter it above.

Does the annual maximum carry over?

Carry-over rules differ by plan, so check yours. This tool assumes the maximum resets in full and unused benefit is lost.

Should I split a big treatment across two plan years?

Only if your dentist says the work can wait. Splitting can lower what you pay because you draw on two maximums, but it also means paying a second deductible and living with the problem longer.

When does my dental plan year reset?

It can be the calendar year or the date your coverage began. Your plan documents state it.

What happens after the maximum is reached?

You pay the full price of covered work until the plan year resets.