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Utah Advantage Copay for 2023

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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.
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% See Claim Payment Schedule
Basic
Fillings, Space Maintainers, Oral Surgery
See Co-Pay Schedule
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
Orthodontics
Children (age 7 through 18)
Discount Only No Coverage
Adults
Discount Only No Coverage
Waiting Periods
Preventive None
Basic 6 Month Waiting Period
Major 12 Month Waiting Period
Orthodontics
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
Not Applicable
Pediatric EHB Annual Max None
Pedriatric Individual EHB Out-of-Pocket Max $375
Pediatric Family EHB Out-of-Pocket Max $750

Co-Pays/Claim Payments are subject to change January 1st of each year. 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.