Annual maximum planner · Your plan numbers · Free
Should I split my dental work across two plan years?
Enter your annual maximum, what you have used so far, and the treatment on your written estimate. See what you would pay if it is all done now, or if part of it waits for the maximum to reset.
On these numbers
Splitting it across the January reset would leave you about $350 less to pay.
- Maximum left this year
- $1,500
- All this year: you pay
- $2,200
- Split: you pay
- $1,850
- Only your dentist can say what can wait. Putting off treatment for pain, infection, a cracked tooth or decay near the nerve usually ends up costing more, and can cost the tooth.
- The deductible usually starts again with the new plan year, which this does not subtract.
- Check that your coverage will still be in force after the reset, and whether a waiting period applies.
- Ask the office for a pre-treatment estimate from the plan before you rely on any of this.
Your own numbers · Not insurance or financial advice · Nothing you enter is saved
How the annual maximum works
A yearly cap on what the plan pays, not on what you pay
Most dental plans stop paying once they have paid a set amount in a plan year, commonly $1,000 to $2,000 per person. After that, the rest of the year is your cost. The amount starts again at the beginning of the next plan year, which is often January but depends on the plan.
That creates a simple planning question when a treatment plan is larger than the maximum. If part of the work can safely be done after the reset, the plan pays toward it from a fresh maximum, and you pay less in total. Dental offices do this routinely and will usually help you work it out.
The word that matters is safely. Decay, infection and cracks do not wait for a plan year, and a filling that becomes a root canal costs far more than the benefit you were trying to save. Your dentist decides the order and the timing. Unused benefits generally do not roll over, so the same arithmetic can also favor having planned work done before the year ends.
Table 1 — Before you plan around a reset
Check with the plan and the office
| When your plan year starts | It is in your plan documents. Not every plan runs January to December. |
| How much of the maximum is left | The plan can tell you what has been paid this year. |
| What your dentist says can wait | And what happens to the tooth in the meantime. |
| Whether you will still be covered | A change of job or plan can change the maximum, the network and the waiting periods. |
| A pre-treatment estimate | Ask the office to send the plan the proposed treatment so you see what it will pay before you start. |
Common questions
- What happens when I reach my dental annual maximum?
- The plan stops paying for the rest of that plan year and you pay the full fee for further treatment, though in-network dentists generally still charge the negotiated rate. The maximum starts again at the beginning of the next plan year.
- Do unused dental benefits roll over?
- Usually not. Most plans do not carry unused benefits into the next year, though a few have a carryover feature. That is why offices often suggest having planned work done before the plan year ends. Check your plan documents to see how yours works.
- Can I split a crown or root canal between two years?
- Sometimes treatment that has separate steps, or a plan with several teeth to treat, can be scheduled on either side of the reset. Whether that is safe depends on the tooth. Ask your dentist; do not delay treatment for pain, infection or a cracked tooth to save on benefits.
- When does my dental insurance reset?
- At the start of your plan year. For many plans that is January 1, but some run on a different twelve months, such as the anniversary of when coverage began or an employer's benefit year. Your plan documents or the plan itself can tell you.
General information · Not dental advice
The planner does arithmetic on your numbers. It is not insurance or financial advice, and only your dentist can say whether any treatment can wait. We always recommend seeing a dentist. Nothing on this site can examine your mouth or tell you what is wrong. If something hurts, looks wrong, or worries you, book an exam, and go sooner if it is getting worse.
Emergency? If you have trouble breathing or swallowing, swelling that is spreading toward your eye or neck, a fever with facial swelling, or bleeding that will not stop, call 911 or go to your nearest emergency room immediately. Full disclaimer
About this tool
This tool gives general, educational information only. It does not know your health history, has not examined you, and cannot diagnose anything or tell you what treatment you need. Use it to prepare for a conversation with your dentist, not to replace one.
Costs and coverage
Information here about dental insurance, Medicare, Medicaid, VA benefits, discount plans and financing is general and may be out of date. Plan terms and program rules differ by plan and by state, and they change. This is not insurance, financial, tax or legal advice, and it does not tell you what any plan covers. Dollar figures are typical US ranges, not quotes. Before you rely on any of it, confirm with your own plan documents, the program itself, and a written estimate from your dental office. Never put off care for pain, swelling or a broken tooth because of cost: be seen, and ask the office about the fee and a payment plan.
Medical disclaimer
The information provided on Urgent Dental Helper is for general informational and educational purposes only. It is NOT intended to be a substitute for professional medical or dental advice, diagnosis, or treatment. Urgent Dental Helper is not a dental practice, and nothing here has examined your mouth. Always see a licensed dentist, physician, or other qualified health provider in person about any dental or medical condition. Never disregard professional advice or delay in seeking it because of something you have read or any result you received on this website.