Utah Advantage Copay for 2021
Take advantage of more savings
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.
The Advantage network gives you the opportunity to save with lower premiums and lower provider fees as a result of a more narrow network. Search Advantage network providers using our Provider Search.
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| Plan Summary | Advantage Network | Out-of-Network |
| Services | ||
|
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
|
100% | See Claim Payment Schedule |
|
Basic
Fillings, Space Maintainers, Oral Surgery
|
See Co-Pay Schedule | |
|
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
|
||
|
Orthodontics
Children (up to age 19*)
|
Up to 25% Discount | Not Covered |
|
All Members (Discount)
|
Up to 25% Discount | No Discount |
| Waiting Periods | ||
| Preventive | None | |
| Basic | 6 Month Waiting Period | |
| Major | 12 Month Waiting Period | |
|
Orthodontics
|
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
|
Not Applicable | |
| Pediatric EHB Annual Max | None | |
| Pedriatric Individual EHB Out-of-Pocket Max | $350 | |
| Pediatric Family EHB Out-of-Pocket Max | $700 | |
Co-Pays/Claim Payments are subject to change January 1st of each year. 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.
*Through the last day of the month in which the Insured turns 19 years of age