What Is a Dental Deductible?

What You'll Learn

When you receive a covered dental service, your insurance applies the cost toward your deductible first. Once you have paid the deductible amount, your insurance begins paying its share of covered services for the rest of the plan year. For example, if your deductible is $100 and you have a filling that costs $200, you pay the first $100 (the deductible) and your insurance pays its percentage of the remaining $100. Once the deductible is met, subsequent covered services are shared according to your plan's coverage percentages.

Most dental plans waive the deductible for preventive services — cleanings, exams, and X-rays are typically covered at 100 percent with no deductible required. This is intentional: insurance companies want to encourage preventive care because it reduces the need for more expensive restorative treatment. The deductible usually applies to basic and major restorative services like fillings, crowns, and root canals.

If you have a family dental plan, there is typically both an individual deductible and a family deductible. The individual deductible applies to each covered person separately. The family deductible is a combined cap — once the family has collectively paid that amount, the deductible is considered met for all family members for the rest of the plan year, even if some individuals have not yet met their individual deductible.

The deductible and the annual maximum are two different limits. The deductible is the minimum you pay before insurance kicks in. The annual maximum is the most your insurance will pay in a plan year. Once you reach the annual maximum, you pay 100 percent of additional costs. Understanding both limits helps you plan treatment timing and budget for dental care.