EMI Premier PPO Low Dental Plan
Looking for quality dental coverage with broad provider access and a high annual maximum—but without the higher premium? The 2025 Premier PPO (Low) plan offers excellent value. You get 100% coverage for preventive care from day one, 75% coverage for basic services after a $50 deductible and 6 months, and 50% for major services, including implants, after a 12-month wait. With a $1,500 annual maximum per adult, this plan balances affordability and strong benefits—perfect for families and individuals who want solid dental care without the extra cost. (Note: This plan does not include orthodontic coverage.)
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
All preventive services—cleanings, exams, fluoride, and X-rays—are covered 100% from day one, with no waiting period or deductible. Staying current with your oral health is easy and affordable when you use in-network providers.
Minor Dental Services
Basic services like fillings, space maintainers, and simple extractions are covered at 75% after meeting your $50 deductible, with a 6-month waiting period. These benefits help reduce your out-of-pocket costs on common dental procedures.
Major Dental Services
Major dental work—including crowns, bridges, root canals, dentures, and implants—is covered at 50% after the deductible, with a 12-month waiting period. These services are also capped at $750 annually per adult, providing helpful support for more extensive treatment needs.
Orthodontia for Children
The Premier PPO (Low) plan does not include orthodontic coverage, but discounts may be available through in-network providers. If braces or aligners are needed, ask your provider about possible reduced rates.
Implant Coverage
Implants are considered a major service under this plan and are covered at 50% after deductible, following a 12-month waiting period. This makes advanced dental restoration more financially manageable.
Maximum Yearly Dental Benefit
This plan includes a $1,500 annual maximum per adult, giving you ample coverage for both preventive and restorative services 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.
