Arizona Dental Plan for 2020

Compare All Dental Plans

Choice PPO Low

The freedom of choice.

What is the Choice PPO Low Plan?

EMI Health's Choice PPO Low Plan is a rich dental benefit plan. This 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.

You can choose to visit dentists in different networks based on your needs. If you use the Advantage network, you'll see more savings. If your dentist isn't in the Advantage network, see if they are in the larger Premier network here: Provider Search

Plan Summary Advantage Network Premier Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
100% 100% 80% up to MAC*
Basic
Fillings, Space Maintainers, Oral Surgery
60% 60% 50% up to MAC*
Major
Crowns, Bridges, Prosthodontics
50% 40% 30% up to MAC*
Orthodontics
(Medically Necessary / Non-Medically Necessary)
50% 50% 50%
Specialists
Member Pays Same As General Dentist
Waiting Periods
Preventive None
Basic 6 Month Waiting Period
Major 18 Month Waiting Period
Orthodontics
(Medically Necessary / Non-Medically Necessary)
None / 24 Month Waiting Period
Deductible
Individual $100
Family Max $300
Maximums
Major Annual Max $500
Annual Max per Person $1,500 $1,000
Orthodontic Lifetime Max
(Medically Necessary / Non-Medically Necessary)
No Maximum / $1,000
Pediatric EHB Annual Max No Maximum
Pedriatric Individual EHB Out-of-Pocket Max $350
Pediatric Family EHB Out-of-Pocket Max $700

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). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge (MAC). Underwritten by EMI Health.