2021 and 2022 HealthCare.gov
Copayment Schedules and EOCs
Find Your Coverage Information
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Click on your plan below to view a PDF of your schedule and Evidence of Coverage. Right click on the link and select "Save As" to save the file on your computer.
2022
| SmartSmile | Copayment Schedule | EOC |
| Super SmartSmile | Copayment Schedule | EOC |
| SmartSmile Plus | Copayment Schedule | EOC |
2021
| SmartSmile | Copayment Schedule | EOC |
| Super SmartSmile | Copayment Schedule | EOC |
| SmartSmile Plus | Copayment Schedule | EOC |
Unsure of your plan name? Log in to your Dental Health Services account for your plan name and more information.