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North Carolina Advantage Copay for 2025

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Advantage Copay Copayment Schedule (PDF)

What is the Advantage Copay Plan?

EMI Health's Advantage Copay Plan is, as the name suggests, a copay plan. This means you have a fixed copay cost for covered dental services and procedures. You can know exactly how much a service or procedure will cost before you visit the dentist with the copay schedule.
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Language Assistance
If you, or someone you’re helping, has questions about the EMI Health Policy, you have the right to get help and information in your language at no cost. To talk to an interpreter, call 800-662-5851 (TTY: 1-888-236-4823).
Plan Summary Advantage Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
 100% See Co-Pay Schedule
Basic
Fillings, Space Maintainers, Oral Surgery
 See Co-Pay Schedule
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
Orthodontics (Up to age 19**)
(Medically Necessary / Non-Medically Necessary)
 50% / Not Covered 50% / Not Covered
Waiting Periods
Preventive None
Basic (age 19 and older) 6 Month Waiting Period
Major (age 19 and older) 12 Month Waiting Period
Orthodontics
(Medically Necessary / Non-Medically Necessary)
 None / Not Applicable
Deductible (applies to Preventive, Basic and Major)
Individual $50
Family Max $150
Maximums
Major Annual Max No Maximum
Annual Max per Person No Maximum
Orthodontic Lifetime Max
(Medically Necessary / Non-Medically Necessary)
 No Maximum / Not Applicable
Pediatric EHB Annual Max No Maximum
Pedriatric Individual EHB Out-of-Pocket Max $425
Pediatric Family EHB Out-of-Pocket Max $850

Benefits illustrated are in summary only. Refer to your Dental Policy for a complete description of benefits, limitations and exclusions.

*All Services are subject to EMI Health Maximum Allowable Charge (MAC). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge (MAC). Underwritten by Educators Health Plans Life, Accident & Health, Inc.

EMI Health Association does not discriminate on the basis of basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

**Through the last day of the month in which the Insured turns 19 years of age

NOTICE: Your actual expenses for covered services may exceed the stated coinsurance percentage because actual provider charges may not be used to determine plan and member payment obligations.