An annual maximum is a limit on insurer payment, not a cash account and not a guarantee that amount will be paid. It is also not a patient out-of-pocket maximum.
“No waiting period” is not 100% reimbursement. It also does not mean coverage is effective before the actual effective date on the policy.
Calendar-year and benefit-year are different. A calendar-year maximum and deductible reset on a calendar schedule; staged benefit-year percentages do not automatically increase every January 1.
Orthodontia is not included in these supplied summaries. Braces and cosmetic whitening are not advertised here as covered.
Worked illustration
If an eligible amount after the deductible is $1,000 and the applicable plan-paid percentage is 10%, the illustrated plan payment is $100 and the patient share is $900, before any other limits or noncovered charges.
An illustration of arithmetic, not a quote or a claim estimate.
Missing teeth can matter. Existing missing teeth can implicate denture and implant-supported-prosthetic exclusions, so replacing an already-missing tooth is not something these summaries promise to cover.
Every plan's official brochure is linked on its card. The brochures supplement the on-page explanation, but they are not the only way to understand a plan, and this page is not a substitute for a state-specific certificate.