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Arizona Advantage Copay for 2025

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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.
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Language Assistance
If you, or someone you’re helping, has questions about the EMI Health Policy, you have the right to get help and information in your language at no cost. To talk to an interpreter, call 800-662-5851 (TTY: 1-888-236-4823).
Plan Summary Advantage Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
100% See Co-Pay Schedule
Basic
Fillings, Space Maintainers, Oral Surgery
See Co-Pay Schedule
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
Orthodontics (Up to age 19*)
50% 50%
Waiting Periods
Preventive None
Basic (age 19 and older) 6 Month Waiting Period
Major (age 19 and older) 12 Month Waiting Period
Orthodontics
(Medically Necessary / Non-Medically Necessary)
None / 24 Month Waiting Period
Deductible (applies to Preventive, Basic and Major)
Individual $50
Family Max $150
Maximums
Major Annual Max (age 19 and older) No Maximum
Annual Max per Person (age 19 and older) No Maximum
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 $425
Pediatric Family EHB Out-of-Pocket Max $850

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. When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge. Co-Pays/Claim Payments are subject to change January 1st of each year. Underwritten by Educators Health Plans Life, Accident and Health, Inc.

*Through the last day of the month in which the Insured turns 19 years of age