How annual maximums work

Your plan pays a percentage of covered care until the total it has paid hits the maximum for the calendar year. Then you pay the rest until January, when it resets to zero. Benefits do not roll over. Deductibles also reset, so care that straddles the new year can mean paying a deductible twice.

If you had a crown planned and have $900 left on your plan, doing it in December uses that $900. Doing it in January uses next year's.

What I prioritize with what is left

Notice what is not on the list: whitening, veneers, or anything I have not already told you that you need. Cosmetic care is rarely covered and should never be scheduled to "use up" a benefit.

• Your second cleaning and exam if you have not had it. Preventive care is usually covered at the highest percentage
• Any filling, onlay or crown I have already recommended and you have been putting off
• The first half of a two-visit treatment, so the second visit lands in the new year on a fresh maximum
• A night guard if grinding is already damaging your teeth

What not to rush

Do not start a large treatment plan in December because of the calendar. Implants, gum grafts and complex restorative work deserve the right timing, not the fastest. And if I told you a spot was fine to watch, that has not changed because it is November.

How we help

Call us and we will verify your remaining maximum, deductible status and what your plan covers for anything on your chart. You get a written estimate showing what insurance is expected to pay and what you would owe. December fills up, so if there is something you want done this year, the earlier you call the more choice you have in appointment times.