An analysis from CareQuest Institute estimates that approximately 32 million US adults’ dental care needs will exceed their dental insurance plan’s annual maximum benefit.
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The report draws on the 2025 State of Oral Health Equity in America survey to understand how many adult respondents reached or exceeded their annual maximum dental benefit in 2024, their sociodemographic characteristics, and how they navigated their dental treatment after reaching this maximum. Key findings include:
- Of adults who reached or exceeded their maximum benefit, nearly half (46%) report that this prevented them from seeking additional dental treatment.
- Eight percent of adults who exceeded their maximum dental benefit in the previous year say they traveled outside the US to receive dental care at some point in time, compared with 3% of adults who did not exceed their maximum.
- The percentage of adults reaching their maximum benefit increased with age — 14% of adults aged 55 and older reached their maximum.
According to the Kaiser Family Foundation, 41% of US adults have debt from medical or dental bills, disproportionally affecting individuals with lower income and people of color. “The findings underscore gaps in dental coverage that may lead to delayed or discontinued care, particularly among older adults and those with limited insurance benefits,” write the authors.
You may also be interested in:
- Oral Health in America: Who Gets Left Behind?, findings from the latest State of Oral Health Equity in America survey that reveal both progress and gaps in access to dental care.
- Lower-Income Families Still Spend More on Dental Care, a visual report finding that lower-income families paid 7.4 times more out-of-pocket for dental care compared to higher-income families.
- Lifelong Oral Health: How Insurance Type Shapes Dental Care Spending, a report examining differences in oral health care spending between Medicaid and commercial insurance plans.