2021 Utah Dental Plans
Here are the plans available through the Federal Health Insurance Marketplace in your state
Utah Family Dental Plan Comparison
CHOICE PPO HIGH | CHOICE PPO | 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% | 1000% up to MAC* | 100% | 100% up to MAC* | 100% | See Claim Payment Schedule |
Basic | 80% | 80% | 80% up to MAC* | 80% | 70% | 70% up to MAC* | 50% | 50% up to MAC* | See CoPay Schedule | |
Major | 50% | 50% | 50% up to MAC* | 50% | 50% | 50% up to MAC* | 25% | 25% up to MAC* | ||
Orthodontics Children (up to age 19**) |
50% | 50% | 50% | Up to 25% Discount | Up to 25% Discount | No Coverage | Up to 25% Discount | No Coverage | Up to 25% Discount | No Coverage |
All Members (Discount) | Up to 25% Discount | Up to 25% Discount | No Discount | Up to 25% Discount | Up to 25% Discount | No Discount | Up to 25% Discount | No Discount | Up to 25% Discount | No Discount |
Waiting Periods | ||||||||||
Preventive | None | None | None | None | ||||||
Basic | 6 Month Waiting Period | 6 Month Waiting Period | 6 Month Waiting Period | 6 Month Waiting Period | ||||||
Major | 15 Month Waiting Period | 18 Month Waiting Period | 12 Month Waiting Period | 12 Month Waiting Period | ||||||
Orthodontics | 24 Month Waiting Period | Not Applicable | Not Applicable | Not Applicable | ||||||
Deductible (applies to Preventive, Basic and Major) | ||||||||||
Individual | $25 | $50 | $50 | $25 | $50 | $50 | $100 | $50 | ||
Family Max | $75 | $150 | $150 | $75 | $150 | $150 | $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) |
$1,000 | No Coverage (Eligible for up to 25% Discount) | Not Applicable | 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 Maxim um Allowable Charge (MAC). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge. 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
These EMI Health dental plans have been reviewed and approved by the Utah Insurance Department. They meet all Federal regulations, fulfilling the requirements of the Affordable Care Act for individuals. General Policy Provisions