Smile Now Utah - No Waiting Period PPO · 97462UT0100001
UnitedHealthcare Insurance Company offers this marketplace health insurance plan (Plan ID 97462UT0100001) 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 2025 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.
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Special Enrollment Periods
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CSR & subsidy reminders
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Standard High On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
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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)
['UTN012']
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 97462UT0100001 · 2025 filing.
Tier 1 in-network40.00% Coinsurance after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1000.0 Dollars per Year
Includes Coverage for White Fillings, Deep Cleanings, Extractions and Other Minor Restorative Procedures
Exclusions: nan
Dental Check-Up for Children
No Charge after deductible
Tier 1 in-networkNo Charge after deductible
Out-of-network50.00% Coinsurance after deductible
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.
Exclusions: nan
Major Dental Care - Adult
75.00% Coinsurance after deductible
Tier 1 in-network75.00% Coinsurance after deductible
Out-of-network75.00% Coinsurance after deductible
Limit: 1000.0 Dollars per Year
Includes Coverage for Crowns, Bridges, Dentures, Root Canals and Surgical Implants
Exclusions: nan
Orthodontia - Adult
Coverage details pending
nan
Exclusions: nan
Orthodontia - Child
75.00% Coinsurance after deductible
Tier 1 in-network75.00% Coinsurance after deductible
Out-of-network75.00% Coinsurance after deductible
Orthodontic treatment must be Medically Necessary.
Exclusions: nan
Routine Dental Services (Adult)
No Charge after deductible
Tier 1 in-networkNo Charge after deductible
Out-of-network50.00% Coinsurance after deductible
Limit: 1000.0 Dollars per Year
nan
Exclusions: nan
Variant attributes
Smile Now Utah - No Waiting Period PPO · Variant 97462UT0100001-01
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2025
CSR Variation Type
Standard High On Exchange Plan
HIOS Product ID
97462UT010
Metal Level
High
Plan ID (Standard Component ID with Variant)
97462UT0100001-01
Plan Marketing Name
Smile Now Utah - No Waiting Period PPO
Plan Variant Marketing Name
Smile Now Utah - No Waiting Period PPO
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
Yes
Network ID
UTN012
Out of Country Coverage
No
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
National Network of providers is available and members may also receive services at aout of network providers.
Service Area ID
UTS012
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
$800 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$400 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$400
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
0.74
First Tier Utilization
100%
Import Date
2024-08-13 20:01:38
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
New
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
$60 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$60
Medical EHB Deductible, In Network (Tier 1), Family Per Group
per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person
per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual
Not Applicable
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
2025-01-01
Plan Expiration Date
2025-12-31
Plan Type
PPO
QHP/Non QHP
On the Exchange
Source Name
SERFF
Plan ID
97462UT0100001
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?
Smile Now Utah - No Waiting Period PPO (97462UT0100001) is a High PPO from UnitedHealthcare Insurance Company in Utah for the 2025 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Smile Now Utah - No Waiting Period PPO 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 Smile Now Utah - No Waiting Period PPO 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 Smile Now Utah - No Waiting Period PPO 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 Smile Now Utah - No Waiting Period PPO?
No, out-of-country services are not covered for this plan.
Does Smile Now Utah - No Waiting Period PPO cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: National Network of providers is available and members may also receive services at aout of network providers.
How do I enroll in or manage payments for Smile Now Utah - No Waiting Period PPO?
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.
