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Washington Premier PPO for 2024

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What is the Premier PPO Dental Insurance Plan?

The Companion Life EMI Health Premier 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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VISIT WAHEALTHPLANFINDER.ORG
Children age up to 19** Adults age 19 and older
Plan Summary Dentemax Network Out-of-Network Dentemax Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, X-rays, Fluoride, Sealants, Space Maintainers
100% 100% up to MAC* 100% 100% up to MAC*
Basic
Fillings
50% after deductible 50% after deductible up to MAC* 50% after deductible 50% after deductible up to MAC*
Major
Crowns, Bridges, Prosthodontics
50% after deductible 50% after deductible up to MAC* Not Covered Not Covered
Orthodontics
Medically Necessary Orthodontics Only
50% 50% Not Covered Not Covered
Waiting Periods
Preventive None
Basic (age 19 and older) 6 Month Waiting Period
Major None
Orthodontics
None
Deductible
Individual $75.00
Family Max $225.00
Deductible Applies To Type 2 & Type 3
Maximums
Annual Max per Person (age 19 and older) $1,000
Orthodontic Lifetime Max
No Maximum
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 Insurance Policy for a complete description of benefits, limitations and exclusions.

*All Services are subject to EMI Health 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