EMI Marketplace Advantage PPO Dental Plan
Experience the EMI Marketplace Advantage PPO Dental Plan, the ultimate solution for your dental health. Enjoy 100% coverage on preventative care, including regular check-ups, with 50% coverage on basic work like fillings after just 6 months. Need major work, like crowns? We've got you covered at 25% after a 12-month waiting period, all with a $1,000 maximum benefit per year. Say goodbye to dental worries and hello to a brighter, healthier smile with our comprehensive plan.
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
$100
Family Deductible
$300
Preventative Care
Invest in your oral health with our EMI Marketplace Advantage PPO Dental Plan, providing 100% coverage on preventative care, ensuring your smile stays vibrant and trouble-free.
Minor Dental Services
With our EMI Marketplace Advantage PPO Dental Plan, you'll receive excellent coverage for minor dental work such as fillings, starting at 50% coverage after just a 6-month waiting period. Your dental health is in good hands.
Major Dental Services
When it comes to major dental work, the EMI Marketplace Advantage PPO Dental Plan has you covered. After a reasonable 12-month waiting period, you'll receive 25% coverage for procedures like crowns. With a maximum benefit of $500 per year allotted for major services, you can address significant dental needs without breaking the bank. Your dental health is our priority.
Orthodontia for Children
For families seeking orthodontic care, our EMI Marketplace Advantage PPO Dental Plan extends its support to children up to 19 years old. With this plan, you can benefit from up to a generous 25% discount on orthodontic services, ensuring your child's dental alignment needs are met affordably. We prioritize your family's oral health and well-being every step of the way.
Implant Coverage
Please note that our EMI Marketplace Advantage PPO Dental Plan does not provide coverage for dental implants. While we offer comprehensive support for a wide range of dental needs, including preventative, basic, and major work, dental implants are not included in our coverage options. We recommend consulting with your dentist for alternative options or specialized implant coverage if needed. Your dental health is essential to us, and we strive to provide transparency about our coverage offerings.
Maximum Yearly Dental Benefit
Under the EMI Marketplace Advantage PPO Dental Plan, you'll have an annual maximum benefit of $1,000, ensuring you have financial assistance for your dental needs. Specifically, there's a dedicated $500 allocation for major dental work. It's important to note that the benefits reset on a 12-month cycle, beginning from the date you enroll in the plan. This structure allows you to plan and budget effectively for your dental care, knowing that you have support when you need it most. Your dental well-being is our priority.
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.
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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.
