Federal Marketplace/Exchange

2024 North Carolina Dental Plans

Here are the plans available through the Federal Health Insurance Marketplace in your state

North Carolina Dental Plan Comparison

We have several dental options for you and your family.
If you see a plan you like, you can then head to the Federal Marketplace to enroll.
VISIT HEALTHCARE.GOV VIEW AS PDF
Premier PPO HIGH Premier PPO LOW ADVANTAGE PPO
Premier Network Out of Network Premier Network Out of Network Advantage Plus Network Out of Network
Services
Preventive 100% 100% up to MAC* 100% 80% up to MAC* 100% 100% up to MAC*
Basic 80% 80% up to MAC* 60% 50% up to MAC* 50% 50% up to MAC*
Major 50% 50% up to MAC* 40% 30% up to MAC* 25% 25% up to MAC*
Orthodontics (Up to age 19**)
(Medically Necessary)
 50% 50% 50% 50% 50% 50%
Orthodontics (Up to age 19**)
(Non-Medically Necessary)
 Not Covered Not Covered Not Covered Not Covered Not Covered Not Covered
Waiting Periods
Preventive None None None
Basic 6 Month Waiting Period 6 Month Waiting Period 6 Month Waiting Period
Major 15 Month Waiting Period 18 Month Waiting Period 12 Month Waiting Period
Orthodontics
(Medically Necessary / Non-Medically Necessary)
 None / Not Applicable None / Not Applicable None / Not Applicable
Deductible (applies to Preventive, Basic and Major)
Individual $25 $50 $100 $75 $100
Family Max $75 $150 $300 $225 $300
Maximums
Major Annual Max (age 19 and older) $750 $500 $500
Annual Max per Person (age 19 and older) $1,000 $1,000 $1,000
Orthodontic Lifetime Max
(Medically Necessary / Non-Medically Necessary)
 No Maximum / Not Applicable No Maximum / Not Applicable No Maximum / Not Applicable
Pediatric EHB Annual Max No Maximum No Maximum No Maximum
Pediatric Individual EHB Out-of-Pocket Max
(up to age 19**)
 $375 $375 $375
Pediatric Family EHB Out-of-Pocket Max
(up to age 19**)
 $750 $750 $750
View Plan Details See Plan Details See Plan Details See Plan Details

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 Educators Health Plans Life, Accident & Health, Inc.

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

These EMI Health dental plans have been reviewed and approved by the North Carolina Insurance Department. They meet all Federal regulations, fulfilling the requirements of the Affordable Care Act for individuals. General Policy Provisions