3500 Maximum Explained

Dental Health
By: Spirit Dental
April 4, 2017

Couple reviewing documents together

Updated 1.11.2021

Let’s face it: medical insurance, including dental insurance, can be really confusing. For example, when shopping around for the right plan, you’ll come across a slew of details, including what’s known as a maximum amount of coverage. But what is a maximum amount, and how does it affect your coverage?

A Spirit Dental plan will come with a $3,500 maximum. What does this mean for you, the patient? We clarify this below so you will know exactly what you should expect when you sign up for a dental plan for yourself or your family.

What’s the Difference Between a Deductible and a Maximum?

Put simply; a deductible is the amount of money that you will be responsible for paying, in addition to your monthly premium. The maximum amount, however, is how much your insurer will pay.  

A deductible is the amount of money that you need to spend before your medical or dental insurance actually kicks in and covers the rest of the costs for you. While other insurance plans force you to pay this deductible once a year, when you enroll in a Spirit plan, you will have a one-time $100 deductible. Once this deductible is reached, you will not be responsible for paying it ever again, and this applies to all coverage options available. Sounds great, right?

Also, when you set up your Spirit plan, you will know in advance what your annual maximum amount of coverage will be, so there won’t be any surprises. This is the maximum dollar amount that the insurer will pay for various dental services and procedures that you receive throughout the year. The higher your maximum, the better, because you’ll be able to rest assured that you’ll be covered even if you need expensive treatments like dental implants.

According to the National Association of Dental Plans, other insurers typically provide their patients with an annual calendar year maximum of $1,000 to $1,500. Not bad. But we can do better. That’s why every Spirit plan offers a maximum of $3,500 annually.* We think that’s worth smiling about!

What Happens When the Maximum Is Met?

Once you have received enough dental care that you’ve hit your $3,500 annual maximum, you will need to pay for any additional services out-of-pocket. If your dentist advises that you can postpone certain dental services, that might be the most cost efficient option, as the maximum will reset the following year.

A Better Way to Be Sure You’re Covered

Spirit plans are designed with the patient in mind. That’s why the $3,500 maximum is one of the unique features of our insurance options for adults, children, and seniors. If you have questions about what plan would best suit your needs, please call us at 844-833-8440

*$3,500 annual maximum plan(s) might not be available in all states

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