UnitedHealthcare Insurance Company offers this marketplace health insurance plan (Plan ID 97462UT0090001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Utah). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard High On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
All providers in UtahN/A
PCPs in UtahN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['UTN011']
Providers
Utah
All US states
All
N/A
N/A
PCP
N/A
N/A
Allergy
N/A
N/A
OB/GYN
N/A
N/A
Dentists
N/A
N/A
Drug coverage overview
0 drugs tracked
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Prior authorization
Drugs
Required
0
Not Required
0
Step therapy
Drugs
Required
0
Not Required
0
Quantity limits
Drugs
Has Limit
0
No Limit
0
Customer highlights
What stands out for members
Issuer: UnitedHealthcare Insurance Company · Plan ID 97462UT0090001 · 2026 filing.
Variant 97462UT0090001-01 (Standard On Exchange Plan) currently displayed.
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Benefits
Covered services & limitations
Pregnancy & family
Maternity, newborn, pediatric dental and vision extras.
Basic Dental Care - Child
$56.00 Copay after deductible
Tier 1 in-network$56.00 Copay after deductible
Out-of-network100.00%
Includes Coverage for Fillings, Deep Cleanings, Extractions and Other Minor Restorative Procedures. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Major Dental Care - Child
$350.00 Copay after deductible
Tier 1 in-network$350.00 Copay after deductible
Out-of-network100.00%
Includes Coverage for Crowns, Bridges, Dentures, Root Canals and Surgical Implants. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Issuer did not share extra notes for this benefit beyond the summary above.
Basic Dental Care - Adult
$60.00
Tier 1 in-network$60.00
Out-of-network100.00%
Includes Coverage for Fillings, Deep Cleanings, Extractions and Other Minor Restorative Procedures. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Dental Check-Up for Children
$5.00 Copay after deductible
Tier 1 in-network$5.00 Copay after deductible
Out-of-network100.00%
Limit: 2.0 Procedure(s) per Benefit Period
Routine cleaning, exams, x-rays and fluoride. Sealants once every five years. Additional covered services included for: space maintainers, diagnostic imaging such as cone beam CT and MRI image captures, lab tests to aid in the detection of cancer and other abnormalities. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Major Dental Care - Adult
$350.00
Tier 1 in-network$350.00
Out-of-network100.00%
Includes Coverage for Crowns, Bridges, Dentures, Root Canals and Surgical Implants. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Orthodontia - Adult
$4,650.00
Tier 1 in-network$4,650.00
Out-of-network100.00%
Includes Comprehensive Cosmetic Orthodontia Coverage for Adult Dentition - D8090
Orthodontia - Child
$350.00 Copay after deductible
Tier 1 in-network$350.00 Copay after deductible
Out-of-network100.00%
Orthodontic treatment must be Medically Necessary. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Routine Dental Services (Adult)
$5.00
Tier 1 in-network$5.00
Out-of-network100.00%
Includes Coverage For Routine Cleanings and Related Services. Various member Copayments apply per specific procedure code of service. For a complete listing of copayments by procedure service code, please refer to the Schedule of Benefits.
Variant attributes
EssentialSmile Utah - Total Care · Variant 97462UT0090001-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2026
CSR Variation Type
Standard High On Exchange Plan
HIOS Product ID
97462UT009
Metal Level
High
Plan ID (Standard Component ID with Variant)
97462UT0090001-01
Plan Marketing Name
EssentialSmile Utah - Total Care
Plan Variant Marketing Name
EssentialSmile Utah - Total Care
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
97462
Issuer Marketplace Marketing Name
UnitedHealthcare
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
No
Network ID
UTN011
Out of Country Coverage
No
Out of Service Area Coverage
No
Service Area ID
UTS011
State Code
UT
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$900 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$450 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$450
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Adult and Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
EHB Apportionment for Pediatric Dental
0.93
First Tier Utilization
100%
Import Date
10/15/2025
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual
Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Group
$30 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$30 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$30
Medical EHB Deductible, Out of Network, Family Per Group
per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person
per person not applicable
Medical EHB Deductible, Out of Network, Individual
Not Applicable
Plan Effective Date
1/1/2026
Plan Expiration Date
12/31/2026
Plan Type
EPO
QHP/Non QHP
On the Exchange
Source Name
SERFF
Plan ID
97462UT0090001
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Utah?
EssentialSmile Utah - Total Care (97462UT0090001) is a High EPO from UnitedHealthcare Insurance Company in Utah for the 2026 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does EssentialSmile Utah - Total Care support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is EssentialSmile Utah - Total Care HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Adult, Child.
Vision coverage is not listed for this plan.
Does EssentialSmile Utah - Total Care support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for EssentialSmile Utah - Total Care?
No, out-of-country services are not covered for this plan.
Does EssentialSmile Utah - Total Care cover care outside the service area?
No, the issuer indicates out-of-service-area care is not covered except for emergencies.
How do I enroll in or manage payments for EssentialSmile Utah - Total Care?
Use the issuer portal https://pay.solsticecare.com to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
