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Texas Advantage Copay for 2023

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Advantage Copay Copayment Schedule (PDF)

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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.
The Advantage network gives you the opportunity to save with lower premiums and lower provider fees as a result of a more narrow network. Search Advantage network providers using our Provider Search.
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Plan Summary Advantage Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
100% 100% up to MAC*
Basic
Fillings, Space Maintainers, Oral Surgery
See Co-Pay Schedule See Co-Pay Schedule
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
Orthodontics (up to age 19**)
50% 50%
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 / 24 Month Waiting Period
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 / $1,000
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 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 (MAC). Underwritten by Educators Health Plans Life, Accident and Health, Inc.

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