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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.

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.

Example:

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

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.

Related Terms

Anniversary Year

An anniversary year is a 12-month benefit period that begins on the date your insurance coverage takes effect rather than on a standard calendar year. This means your plan’s annual maximums, deductibles, and claim resets follow your personal enrollment date instead of January 1 to December 31.

Overall Plan Maximum

An overall plan maximum is the total amount your health and dental plan will pay for all combined benefits within a single policy year. Once the limit is reached, you must pay any additional expenses out of pocket until the next renewal period.

Effective Date

The effective date is the day your insurance coverage officially begins. From this date forward, you are eligible to receive benefits for covered health, dental, life, or disability expenses under the terms of your policy. The effective date is established once your application has been approved, all requirements are met, and the first premium payment has been received, unless otherwise specified in the policy.

Term Life Insurance

Term life insurance provides financial protection for a specific period of time, known as the term, such as 10, 20, or 30 years. If the insured person dies during that period, the insurer pays a tax-free lump-sum death benefit to the designated beneficiary. This type of insurance is designed to provide affordable coverage for temporary needs, such as replacing income, paying off a mortgage, or supporting dependents until financial independence is achieved.

Benefit Period (Vision)

The benefit period for vision refers to how often your vision care coverage renews and allows you to make new claims for eligible expenses such as glasses, contact lenses, or eye exams. Unlike other benefits that reset each year, vision care often renews every two benefit periods, which can mean every 24 consecutive months rather than every calendar year.

Relevant Plans

Plans that relate to Annual Maximum (Overall Plan)

Alberta Blue Cross - Blue Assured - Basic

Alberta Blue Cross - Blue Assured - Basic

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced

Alberta Blue Cross - Blue Assured - Enhanced

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced+

Alberta Blue Cross - Blue Assured - Enhanced+

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Premium

Alberta Blue Cross - Blue Assured - Premium

Can apply at anytime, at any age.

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