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South Carolina Advantage Copay for 2024

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Advantage Copay Copayment Schedule (PDF)

What is the Advantage Copay Dental Insurance Plan?

The Companion Life EMI Health Advantage Copay Dental Insurance 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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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
See Co-Pay Schedule
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
Orthodontics (up to age 19*)
(Medically Necessary)
50% 50%
Orthodontics (up to age 19*)
(Non-Medically Necessary)
Discount Only 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)
None
Orthodontics
(Non-Medically Necessary)
Not Applicable
Deductible (applies To Preventive, Basic and Major)
Individual $50.00
Family Max $150.00
Maximums
Major Annual Max No Maximum
Annual Max per Person No Maximum
Orthodontic Lifetime Max
(Medically Necessary)
Not Maximum
Orthodontic Lifetime Max
(Non-Medically Necessary)
Not Applicable
Pediatric EHB Annual Max No Maximum
Pedriatric Individual EHB Out-of-Pocket Max $375
Pediatric Family EHB Out-of-Pocket Max $750

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

All Services are subject to EMI Health Maximum Allowable Charge. When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge. Co-Pays/Claim Payments are subject to change January 1st of each year. Underwritten by Companion Life Insurance Company.

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