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Utah Choice PPO High for 2021

The freedom of choice

Compare Family Dental Plans Compare Pediatric Dental Plans

What is the Choice PPO High Plan?

EMI Health's Choice PPO Plan is a rich dental benefit plan at a reasonable cost. 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.
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Plan Summary Advantage Network Premier Network Out-of-Network
Services
Preventive
Oral Exams, Cleanings, Sealants, X-rays, Fluoride
 100% 100% 100% up to MAC*
Basic
Fillings, Space Maintainers, Oral Surgery
 80% 80% 80% up to MAC*
Major
Crowns, Bridges, Prosthodontics, Endodontics, Periodontics
 50% 50% 50% up to MAC*
Orthodontics
Children (up to age 19**)
 50% 50% 50%
All Members (Discount)
 Up to 25% Discount Up to 25% Discount No Discount
Waiting Periods
Preventive None
Basic 6 Month Waiting Period
Major 15 Month Waiting Period
Orthodontics
 24 Month Waiting Period
Deductible (applies to Preventive, Basic and Major)
Individual $25 $50 $50
Family Max $75 $150 $150
Maximums
Major Annual Max $750
Annual Max per Person $1,500 $1,000
Orthodontic Lifetime Max
 $1,000
Pediatric EHB Annual Max No Maximum
Pedriatric Individual EHB Out-of-Pocket Max $350
Pediatric Family EHB Out-of-Pocket Max $700

*All Services are subject to EMI Health Maxim um Allowable Charge (MAC). When using a Non-participating Provider, the insured is responsible for all fees in excess of the Maximum Allowable Charge. 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