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Missouri Advantage Copay for 2024

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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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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*)
(Medically Necessary / Non-Medically Necessary)
 50% / Discount Only 50% / Not Covered
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 / Not Applicable
Deductible (applies to Preventive, Basic and Major)
Individual $50
Family Max $150
Maximums
Major Annual Max No Maximum
Annual Max per Person No Maximum
Orthodontic Lifetime Max
(Medically Necessary / Non-Medically Necessary)
 No Maximum / Not Applicable
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 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.