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2023 Utah Pediatric Dental Plans

Here are the plans available through the Federal Health Insurance Marketplace in your state

Looking for 2021 Plans?

Compare Family Dental Plans

Utah EHB Pediatric Advantage & Premier Comparison

We have several dental options for you and your family.
If you see a plan you like, you can then head to the Federal Marketplace to enroll.
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Plan Summary EHB Pediatric (Advantage) EHB Pediatric (Premier)
Network
Advantage Network Only Premier Network Only
Routine cleanings, exams, fluoride, x-rays and sealants
70% 70%
Out of Pocket Max
$375 Individual / $750 Family $375 Individual / $750 Family
Pediatric Annual Maximum
No Maximum No Maximum
Oral Examinations
Periodic oral exam fees are allowed twice in a plan year. A re-evaluation is considered included in the primary procedure and is not payable separately. Periodic oral exam fees are allowed twice in a plan year. A re-evaluation is considered included in the primary procedure and is not payable separately.
Diagnostic x-rays/services

Complete mouth x-rays (posterior bitewing films and 14 periapical films plus bitewings) are allowed once during any three-year period for members age 13 through the last day of the calendar year in which the Insured turns 19 years of age, in lieu of panorex x-ray.

Full series bitewing x-rays (4) are allowed only twice in a plan year.

A panorex is allowable once during any three-year period in lieu of complete mouth x-ray.

Vertical bitewings are payable up to eight films.

Complete mouth x-rays (posterior bitewing films and 14 periapical films plus bitewings) are allowed once during any three-year period for members age 13 through the last day of the calendar year in which the Insured turns 19 years of age, in lieu of panorex x-ray.

Full series bitewing x-rays (4) are allowed only twice in a plan year.

A panorex is allowable once during any three-year period in lieu of complete mouth x-ray.

Vertical bitewings are payable up to eight films.

Preventive

Prophylaxis (cleaning) is allowed twice in a plan year. A child Prophylaxis will be allowed through age 13. An adult Prophylaxis will be allowed for age 14 through the last day of the calendar year in which the Insured turns 19 years of age.

Application of fluoride in conjunction with cleaning, 2 times in a plan year.

Sealants on permanent molars are allowed once during any five-year period. Permanent molars include teeth numbers 1, 2, 3, 14, 15, 16, 17, 18, 19, 30, 31, and 32. (Permanent molars with occlusal restoration are ineligible.)

Prophylaxis (cleaning) is allowed twice in a plan year. A child Prophylaxis will be allowed through age 13. An adult Prophylaxis will be allowed for age 14 through the last day of the calendar year in which the Insured turns 19 years of age.

Application of fluoride in conjunction with cleaning, 2 times in a plan year.

Sealants on permanent molars are allowed once during any five-year period. Permanent molars include teeth numbers 1, 2, 3, 14, 15, 16, 17, 18, 19, 30, 31, and 32. (Permanent molars with occlusal restoration are ineligible.)

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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 (MAC). Unless otherwise noted, coverage is effective through the last day of the calendar year in which the insured turns 19 years of age. Underwritten by Educators Health Plans Life, Accident, and Health, Inc.

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