EMI Advantage PPO Dental Plan
If you're looking for comprehensive dental coverage with access to a broad PPO network, the 2025 Advantage PPO Dental Plan is an excellent choice. This plan covers 100% of preventive services like cleanings, exams, and X-rays with no waiting period. After a $50 deductible per person, it covers 75% of basic care—including fillings and simple extractions—after just 6 months, and 50% of major services, like crowns, bridges, and even implants, after 12 months. With a generous $1,500 annual maximum benefit per adult, this plan gives you the freedom to get the care you need while keeping costs predictable and manageable.
Carrier
EMI
Plan Year
2025
Individual and Family Deductible
Dental insurance deductibles work similarly to health insurance deductibles, but they apply specifically to dental care. Individual deductibles are the amount a person must pay out-of-pocket for covered dental services before the insurance starts covering a portion of the costs. In a family plan, each family member has their own individual deductible, but many plans also have a family deductible cap, meaning once the family’s combined spending reaches a certain limit, the insurance will kick in for all members. These deductibles generally apply to services like fillings, crowns, and other restorative treatments, but routine care such as cleanings and exams may be covered without needing to meet the deductible. Understanding how these work ensures you're prepared for any out-of-pocket costs when seeking dental care.
Individual Deductible
$50
Family Deductible
$150
Preventative Care
Preventive dental care is fully covered at 100% from day one when you visit an in-network provider. This includes essential services like oral exams, routine cleanings, X-rays, sealants, and fluoride treatments. There’s no deductible and no waiting period, making it easy and affordable to stay on top of your oral health.
Minor Dental Services
Basic dental services—such as fillings, space maintainers, and simple extractions—are covered at 75% after the $50 deductible and are available after a short 6-month waiting period. Whether it’s a small cavity or a quick fix, this plan helps you take care of common dental needs without breaking the bank.
Major Dental Services
Major dental procedures, including crowns, bridges, root canals, dentures, and implants, are covered at 50% after the deductible, with a 12-month waiting period. These are typically the most expensive dental treatments, so having half the cost covered gives you great protection when you need more serious care.
Orthodontia for Children
While there is no direct orthodontic coverage for children, the plan does offer discounts through participating providers for kids under 19. This helps make orthodontic treatments like braces or retainers more affordable for growing families.
Implant Coverage
Unlike many dental plans, the Advantage PPO includes coverage for implants as part of its major services category. After a 12-month waiting period and meeting the deductible, 50% of the cost is covered—making dental implants more accessible and affordable than ever.
Maximum Yearly Dental Benefit
Each adult enrolled in the plan gets an annual maximum of $1,500 in coverage, giving you plenty of room to handle cleanings, fillings, and even major dental work within a year. This benefit limit helps ensure you're supported through both routine and unexpected dental needs.
Full Summary of Benefits and Helpful Links
Official documents, such as your insurance policy or Summary of Benefits and Coverage (SBC), outline the details of your coverage, including deductibles, copayments, and covered services. Provider links, often available through your insurance company's website, offer directories of in-network healthcare professionals and facilities, helping you find the right dentists that are covered by your plan. Utilizing these resources can empower you to make informed healthcare decisions and effectively navigate your insurance coverage.
Helpful Links
Schedule a consultation with a local health insurance agent
We're happy to meet with your in-person or over the phone to help you with your health insurance needs. We can help you with health insurance on or off the marketplace, Medicare Advantage & supplements, dental insurance, vision insurance, life insurance or accident plans. Thank you for letting us be your advocate. Best part, is our help is always free!
This is a quick snapshot of the most popular copays, deductibles, and coinsurance that you would be responsible for on this dental plan. Preventative services include dental cleanings, exams and x-rays. Most plans cover your preventative care every 6 months with no waiting period. Basic dental work includes minor services like filling a cavity and may have a waiting period before these services will be covered on your plan. Major work includes services like crowns and root canals and may have a waiting period before these services are covered. Dentures and implants are normally NOT included in dental insurance. If you need coverage for these services, please let your local agent know so that you have a plan that includes those services.
To learn what each of the terms mean, please visit our terms and definitions page. Copays and coinsurance listed are amounts that you would pay after deductible unless specified otherwise. This is not a full list of services included on the plan. This snapshot is not guaranteed to be accurate. To verify plan benefits or for full details please see the full summary of benefits or or get a complete terms of coverage on the health plan carrier's website.
PPO Plans and Out of Network Limitations and Balance Billing
Some dental plans offer out of network coverage. This is a great benefit because you can visit any dentist in the nation. Which means that if you are traveling, or have a dental emergency, you can visit a dentist for the service you need right away and have a portion of your bill covered by your dental insurance. Please note that if you see an out of network provider, that dentist is allowed to "balance bill" you. This means that your dental insurance company pays your dentist what is reasonable and customary for the services you received. In most situations that dentist accepts that payment and you are only responsible for your portion of the bill. Occasionally, that dentist will decide that the reasonable and customary amount they received from the dental insurance is not enough. That dentist will bill you for the additional charge or 'balance bill' you. You are responsible to pay this amount and contact the dentist to work out a payment plan.
