Washington WA Individual Advantage PPO for 2024
Take advantage of more savings
What is the Advantage PPO Dental Insurance Plan?
The Companion Life EMI Health Advantage PPO Dental Insurance Plan is a coinsurance plan, which means we share your costs for covered dental services and procedures. Once you've met your deductible, we'll pay a percentage of your bill.
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| Plan Summary | Dentemax | Out-of-Network |
| Services | ||
|
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
|
100% | 100% up to MAC* |
|
Basic
Fillings, Space Maintainers, Oral Surgery
|
80% after deductible | 80% after deductible up to MAC* |
|
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
|
50% after deductible | 50% after deductible up to MAC* |
|
Orthodontics (Up to age 19*)
(Medically Necessary / Non-Medically Necessary)
|
50% / 50% | 50% / 50% |
| Waiting Periods | ||
| Preventive | None | |
| Basic (age 19 and older) | 6 Month Waiting Period | |
| Major (age 19 and older) | 6 Month Waiting Period | |
|
Orthodontics
|
None | |
| Deductible (applies to Preventive, Basic and Major) | ||
| Per Person | $85 | |
| Family Max | $225 | |
| Maximums | ||
| Major Annual Max (age 19 and older) | $750 | |
| Annual Max per Person (age 19 and older) | $1,000 | |
|
Orthodontic Lifetime Max
|
No Maximum | |
| Pediatric EHB Annual Max | No Maximum | |
| Pediatric 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 Maximum Allowable Charge (MAC). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge (MAC). Underwritten by Companion Life Insurance Company.
**Through the last day of the month in which the Insured turns 19 years of age