Annual Maximum (Overall Plan)

The annual maximum is the most your insurance plan will pay for a specific benefit within a 12-month period (calendar year or benefit year). Once you reach this limit, additional expenses for that category become your responsibility until the next year.

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For instance, a plan might cover up to $300 per year for massage therapy or $1,000 for dental care. Annual maximums help control claims costs and encourage sustainable use of benefits. They can apply per person or per family and often increase with higher-tier plans.

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Example:

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If your dental annual maximum is $1,000 and you’ve claimed $850, only $150 remains for the rest of the year.

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What to Watch For:

• Some carriers use a combined annual maximum across multiple services.
• Unused amounts rarely carry forward.
• Check if your plan uses calendar year or anniversary year resets.