GET TO KNOW YOUR COVERAGE

Your EMI Health Dental Plan

Learn how your plan works, what’s covered, and how to get the most from your dental coverage.

 

Be sure to check your plan summary(ies)—found at the back of your enrollment booklet to see which dental plan(s) you may choose from.

Regardless of type of plan, with EMI Health, you have access to a nationwide network of trusted dentists, making it easier to get care wherever you are.


WHATS INCLUDED IN YOUR DENTAL COVERAGE

Understand the four main types of dental care—and how your plan helps cover each one.

  • Preventive Care

  • Basic Services

  • Major Services

  • Orthodontics

icon_dental_cleaning@300xIncludes cleanings, checkups, and routine X-rays. These are usually covered at a higher level and may not require you to pay anything out-of-pocket when you use an in-network provider.

icon_dental_extractions@300xIncludes treatments like fillings and simple extractions. These services are often shared between you and the plan, depending on your specific benefits.

icon_dental_crowns@300xIncludes crowns, bridges, dentures, and other more involved procedures. These are typically covered at a lower percentage and may come with higher out-of-pocket costs.
icon_dental_ortho@300xCovers braces and other alignment services. If your plan includes orthodontic coverage, it typically has a lifetime maximum per person. This means the plan will only pay up to a certain amount for orthodontic care—ever.

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Where to Find Your Coverage Details

Every dental plan is a little different. To see exactly what your plan covers for each type of care—check the benefits summary in your enrollment booklet. 

HOW MUCH DOES THE PLAN PAY?

A Few Important Things to Know

The amount your plan pays depends on the type of care and your specific dental plan. Each category—preventive, basic, major, and orthodontic—may be covered at different levels.

 

To find out exactly how your plan pays for care, refer to the plan summary in the back of your enrollment booklet.

Deductible

A deductible is the amount you pay out of pocket each year for certain dental services before your insurance begins to pay its portion. Deductibles may apply per person and per family, depending on your plan.

Waiting Periods

A waiting period is the amount of time you must be enrolled in your dental plan before certain types of care are covered. While preventive services like cleanings and exams are usually covered immediately, other services may have a delay.

Annual Maximum

The total amount the plan will pay for dental care each year. This maximum is usually listed as per person and per family. Once you reach this amount, you’ll pay any additional costs out-of-pocket.

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QUESTIONS TO ASK YOURSELF

Choosing the Right Dental Plan

Picking the right dental plan depends on your needs. Here’s some things to consider:

Is your current dentist in-network?

Use our Provider Search Page to check before you choose a plan. Staying in-network saves you money.

Do you or your family need orthodontic coverage?

If braces are on the horizon, look for a plan that includes orthodontics.

Do you expect major dental work soon?

Crowns, root canals, or dentures can get expensive. A plan with strong coverage for major services may help.

What can you afford each month?

Review the monthly rates and balance what you’re paying with what you expect to use.

Do you want flexibility or lower costs?

Some plans give you more dentist choices (but cost more). Others keep costs down if you stay in-network.
STATE-BY-STATE COVERAGE

EMI Health Dental Networks by State

  • Utah

  • Arizona

  • Texas

  • Georgia

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Utah Networks

When it comes to dental coverage in Utah, EMI Health offers one of the most robust provider networks in the state. Between our contracted networks, members have access to thousands of dentists, specialists, and facilities—making it easy to find the care you need, close to home.

  • Premier
  • Advantage
  • Advantage Plus
  • Utah DHMO
  • Utah Value

Out-of-State Coverage: For services outside Utah, your plan will utilize a different network, providing nationwide access to quality care.  Check your ID card for the Out-of-State Network for your plan.

Need to find a provider near you?
Whether you're in a city or a rural area, chances are there's an in-network provider near you. Use our Provider Search Tool to explore your options and take full advantage of your plan.
 
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Arizona: Consistent Coverage In and Out of State

If you're enrolled in an EMI Health plan in Arizona, you'll use the same network both in-state and when traveling out of state—making it easy to get care wherever you go. The only exception is Utah, where EMI Health uses its own Care Plus Network.

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Texas: Aetna or Cigna PPO

In Texas, EMI Health partners with two well-established national networks—Aetna and Cigna—to ensure broad, dependable access to care across the state.

  • Aetna PPO: Recognized for its large, well-coordinated provider network, Aetna offers strong access to primary care, specialists, and hospitals, with a reputation for responsive customer support and a seamless member experience. Search for Texas Aetna Providers here

  • Cigna PPO: Cigna brings a robust network of healthcare professionals and facilities, with a strong focus on preventive care, care coordination, and tools that help members stay healthy and informed. Search for Texas Cigna Providers here

No matter which network your plan uses, you can count on access to high-quality care throughout Texas and beyond.

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Georgia: Trusted Coverage Through Aetna or Cigna PPO

EMI Health members in Georgia are covered through either the Aetna PPO or Cigna PPO network—two nationally recognized carriers known for quality care and broad access.

  • Aetna PPO: Aetna is known for its reliable network of doctors, hospitals, and specialists throughout Georgia. Members benefit from a strong emphasis on preventive care and tools to manage their health with confidence.

  • Cigna PPO: With a wide-reaching network and a strong presence in both urban and rural parts of Georgia, Cigna focuses on whole-person care, making it easier to stay on top of both routine and specialized health needs. Search for Georgia Cigna PPO Providers

Whether you're in Atlanta or a smaller community, these networks ensure access to high-quality providers across the state—and throughout the U.S.

 

MAKE SURE YOUR PROVIDER IS COVERED UNDER YOUR PLAN

How to Search for In-network Providers

To get the most from your EMI Health benefits—and avoid unexpected costs—it’s important to see providers in your plan’s network. That starts with two simple steps:

 Step 1: Find Your Plan’s Network 

Before you search, you’ll need to know which network your plan uses. You can find this in your plan summary, located in the back of your enrollment booklet or in your EMI Health member portal after you enroll.

dental_network_summaryLook for names like:

  • Premier
  • Advantage (Plus)
  • DHMO
  • Summit
  • Or other regional or specialty networks

 Step 2: Use the Provider Search Tool 

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Visit: emihealth.com/ProviderSearch
Then follow these steps:

  1. Select your network from the dropdown list. (Use the name you found in your plan summary.)
  2. Choose your provider type (e.g., dental, medical, vision).
  3. Enter your ZIP code or city to see local providers.
  4. Filter by specialty, gender, language, or other preferences.

Why It Matters

Seeing an in-network provider means:

  • Lower out-of-pocket costs
  • No surprise billing
  • Simplified claims and coverage

If you're unsure about your network, reach out to EMI Health Member Services—we're here to help you find the care you need.

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 Start Your Search for In-Network Care

Out-of-Network Coverage: MAC vs. R&C

If you visit a dentist who isn't part of your plan's network, your dental insurance will determine how much it pays based on one of two methods:

Feature MAC (Maximum Allowable Charge) R&C (Reasonable & Customary)
How reimbursement is calculated Limited to the plan's max allowoable  Based on average fees in your area for similar services
Plan payment Limited to the plan's max allowable amount Based on typical local charges (often higher than MAC)
Your cost You pay the difference if your dentist charges more than the plan allows You pay the difference if the charge exceeds the "customary" limit
Flexibility Lower reimbursement out-of-network More generous reimbursement out-of-network
Best for Members who stay in-network Members who may need to go out-of-network
Typical reimbursement level Lower Often higher than MAC

 

Tip: To minimize unexpected expenses, always check if your dentist is in-network using our Provider Search Page. For detailed information about your plan's out-of-network coverage, refer to your plan summary located at the back of your enrollment booklet or access your plan documents through the EMI Health member portal after enrollment.

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REAL HELP FROM REAL PEOPLE

Customer Service

Whether you’re looking for help with benefits, claims, ID cards, or something else—we’ve got a knowledgeable, friendly team ready to assist.

Call our Member Services team
(800) 262-5851
Monday - Friday 6:00 am - 6:00 pm

 

OR send us an email at cs@emihealth.com

We’re committed to making your experience as smooth as possible. If something doesn’t make sense, just ask—we’ll walk you through it.