Combined Dental Maximum

A combined dental maximum is the shared annual limit your insurance plan will pay for multiple categories of dental services grouped together under one total. Instead of assigning separate dollar caps to preventive, basic, and restorative care, the insurer combines them into a single yearly maximum. Once that combined amount is reached, no further reimbursement is available for any of those services until the next benefit period.

This approach simplifies plan administration while helping control overall costs. For example, a plan might offer a $1,500 combined maximum that applies to cleanings, fillings, and crowns. How you use that total is flexible - you can apply it entirely to one type of service or spread it across several, as long as you stay within the combined limit.

Combined maximums are most common in personal health and dental plans or guaranteed-issue policies where flexibility and simplicity are emphasized over unlimited coverage.

Example:

If your plan has a $1,500 combined dental maximum and you claim $300 for cleanings, $700 for fillings, and $500 for a crown, you will have reached your $1,500 limit for the year. Any additional dental costs will not be reimbursed until the plan renews.

What to Watch For:

Track your cumulative dental claims throughout the year. Even if your coinsurance applies, the plan stops paying once you reach the combined total. Also check whether orthodontic services have their own separate lifetime maximum or fall within the same combined pool.

See also Combined Maximum