EMI Premier PPO High Dental Plan
If you want top-tier dental coverage with broad access to general and specialty providers, the 2025 Premier PPO (High) plan is your best choice. It covers 100% of preventive care right away with no waiting period, 80% of basic services after a $75 deductible and 6 months, and 50% of major services, including implants, after 12 months. Plus, it offers orthodontic coverage for kids up to $1,250 (after an 18-month wait) and a high annual maximum of $2,500 per adult, giving you more room to handle regular and unexpected dental needs with peace of mind.
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
$75
Family Deductible
$225
Preventative Care
Preventive dental care is covered at 100% with no waiting period, helping you stay on track with routine cleanings, exams, fluoride treatments, and X-rays. There’s no deductible for these services, and you’ll save the most by visiting in-network providers.
Minor Dental Services
Basic services such as fillings, simple extractions, and space maintainers are covered at 80% after the $75 deductible, with a 6-month waiting period. These benefits help you handle everyday dental needs at a lower out-of-pocket cost.
Major Dental Services
Major procedures—including crowns, bridges, dentures, root canals, and implants—are covered at 50% after the deductible, with a 12-month waiting period. These treatments are also subject to an annual cap of $1,250 per person for major care.
Orthodontia for Children
This plan includes orthodontic benefits for children up to age 19, covering 50% of the cost up to a lifetime maximum of $1,250, after an 18-month waiting period. Adults can also receive discounted rates through in-network providers, though coverage is not included.
Implant Coverage
Implants are included as part of major dental services and are covered at 50% after the deductible, with a 12-month waiting period. With this plan, you get real financial help for one of the most expensive dental procedures.
Maximum Yearly Dental Benefit
This plan provides a generous $2,500 annual maximum benefit per adult, giving you flexibility to cover both routine care and more extensive dental treatments throughout the year.
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.
