2021 Ohio Dental Plans
Here are the plans available through the Federal Health Insurance Marketplace in your state
Ohio Dental Plan Comparison
| CHOICE PPO HIGH | CHOICE PPO LOW | ADVANTAGE PPO | ADVANTAGE COPAY | |||||||
| Advantage Network | Premier Network | Out of Network | Advantage Network | Premier Network | Out of Network | Advantage Network | Out of Network | Advantage Network | Out of Network | |
| Services | ||||||||||
| Preventive | 100% | 100% | 100% up to MAC* | 100% | 100% | 80% up to MAC* | 100% | 100% up to MAC* | 100% | See CoPay Schedule |
| Basic | 80% | 80% | 80% up to MAC* | 60% | 60% | 50% up to MAC* | 50% | 50% up to MAC* | See CoPay Schedule | |
| Major | 50% | 50% | 50% up to MAC* | 50% | 40% | 30% up to MAC* | 25% | 25% up to MAC* | ||
|
Orthodontics (up to age 19**) (Medically Necessary / Non-Medically Necessary)
|
50% | 50% | 50% | 50% / Discount Only (Up to 25%) | 50% / Discount Only (Up to 25%) | 50% / Not Covered | 50% / Discount Only (Up to 25%) | 50% / Not Covered | 50% / Discount Only (Up to 25%) | 50% / Not Covered |
| Waiting Periods | ||||||||||
| Preventive | None | None | None | None | ||||||
| Basic (age 19 and older) | 6 Month Waiting Period | 6 Month Waiting Period | 6 Month Waiting Period | 6 Month Waiting Period | ||||||
| Major (age 19 and older) | 15 Month Waiting Period | 18 Month Waiting Period | 12 Month Waiting Period | 12 Month Waiting Period | ||||||
|
Orthodontics (Medically Necessary / Non-Medically Necessary)
|
None / 24 Month Waiting Period | None / Not Applicable | None / Not Applicable | None / Not Applicable | ||||||
| Deductible (applies to Preventive, Basic and Major) | ||||||||||
| Individual | $25 | $100 | $100 | $50 | ||||||
| Family Max | $75 | $300 | $300 | $150 | ||||||
| Maximums | ||||||||||
| Major Annual Max | $750 | $500 | $500 | No Maximum | ||||||
| Annual Max per Person | $1,500 | $1,000 | $1,500 | $1,000 | $1,000 | No Maximum | ||||
| Orthodontic Lifetime Max (Medically Necessary / Non-Medically Necessary) |
No Maximum / $1,000 | No Maximum / Not Applicable | No Maximum / Not Applicable | No Maximum / Not Applicable | ||||||
| Pediatric EHB Annual Max | No Maximum | No Maximum | No Maximum | No Maximum | ||||||
| Pediatric Individual EHB Out-of-Pocket Max | $350 | $350 | $350 | $350 | ||||||
| Pediatric Family EHB Out-of-Pocket Max | $700 | $700 | $700 | $700 | ||||||
| View Plan Details | See Plan Details | See Plan Details | See Plan Details | See Plan Details | ||||||
*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). Benefits illustrated are in summary only. Refer to your Dental Policy for a complete description of benefits, limitations and exclusions. Underwritten by Educators Health Plans Life, Accident & Health, Inc.
**Through the last day of the month in which the Insured turns 19 years of age
These EMI Health dental plans have been reviewed and approved by the Ohio Insurance Department. They meet all Federal regulations, fulfilling the requirements of the Affordable Care Act for individuals. General Policy Provisions