Dental Value Plan C550
- Preventive services are 100% covered after a $10 office visit co-payment
- Most other common dental procedures are covered for a fixed co-payment, so there are no hidden costs
- Specialist services may be discounted at 25% off normal fees
- For any procedure not specifically listed, you may receive a discount off the dentist’s normal fees
- No deductibles
- No claims to file
- No waiting periods
- No benefit maximums
Under our C Series DHMO plans, you must select a primary dentist from the Humana DHMO network. Your primary dentist will provide all your routine dental care. When you visit your primary care dentist, simply present your Humana identification card. You may be required to pay a co-payment for some services provided by your primary care dentist. If the dental services provided are not listed as covered procedures under the plans. Discounts may be available.
Should you require the services of a specialist, you can choose any in-network specialist under the Humana DHMO plan. All in-network specialists have agreed to provide Humana members a 25% discount for all procedures.
The co-payments or discounted charges are billed at the time of service and will be the full portion of your cost for dental services, so there are no claim forms to file. You pay your dentist directly, if applicable.
|White Filling:||From $50|
|Root Canals:||From $250|
|Fee Schedule | Dentist Search||Exams:|
|No charge for Periodic oral examination||Cleanings:|
|No charge for routine cleaning – Prophylaxis (once every 6 months)||X-Rays:|
|No charge. See Fee Schedule for limitations and details||Fillings:|
|$30 for Amalgam filling-one surface, primary or permanent|
$50 for (white filling) Resin based composite-one surface, anterior
$90 for Resin based composite-one surface, posterior
|$35 for (Simple) Extraction, erupted tooth or exposed tooth||Crowns:|
|$370* for crown-porcelain fused to noble metal. See complete fee schedule for different types of crowns covered||Root Canals:|
|$250 for Root canal therapy-anterior (excluding final restoration)|
$450 for Root canal therapy-molar (excluding final restoration)
|$375* for complete denture (maxillary)|
$375* for complete denture (mandibular)
|$65 for Periodontal maintenance||Implants:|
|Unlisted procedures are at the participating dentist’s usual fee less 25%||Braces/Orthodontia:|
|Members can receive a 25% savings by visiting an in-network orthodontist||Teeth Whitening:|
|Unlisted procedures are at the participating dentist’s usual fee less 25%||Additional Network Information:|
Under our C Series DHMO plans, you must select a primary dentist from the Humana DHMO network. Your primary dentist will provide all of your routine dental care. When you visit your primary care dentist, simply present your Humana identification card. You may be required to pay a co-payment for some services provided by your primary care dentist. If the dental services provided are not listed as covered procedures under the plans. Discounts may be available.
Should you require the services of a specialist, you can choose any in-network specialist under the Humana DHMO plan. In-network specialists may provide Humana members a 25% discount for all procedures.
The co-payments or discounted charges are billed at the time of service and will be the full portion of your cost for dental services, so there are no claim forms to file. You pay your dentist directly, if applicable.Exclusions and Limitations: N/A
Can I change my dentist once I am in the plan?
Yes. You can easily change dental offices by calling Member Services.
What is a pre-existing condition versus work-in-progress? Is it covered?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The plan does not include an exclusion for pre-existing conditions.
Work in progress is dental work that was started prior to joining the plan. The dentist who started the dental work must complete work in progress after joining the dental plan. Work in progress is not covered.
What provider options do I have?
When you enroll in the Humana Plan, you and each enrolled family member must choose a Selected Participating Dental Office from the Humana network. Each family member may select a different dental office.
When can I start using my Plan?
You can start using your plan once it goes into effect - usually the 1st of the month following your enrollment (as long as the enrollment and payment is received within the enrollment deadline). Incomplete enrollment forms or failure to submit the required initial premium amount may cause an initial delay in issuance of insurance. Do not cancel any other insurance or assume you are insured under the Plan until you receive your certificate of insurance.
When will I receive my new member kit and what will it include?
After a member enrolls in this dental plan, an ID card will be sent via postal mail. Additional member materials, such as Certificate of Coverage and Summary of Benefits, are available to the member on Humanamember.com
Who can enroll in this plan?
You may enroll yourself and your dependents, provided you reside or work in the service area. The Service Area is the geographical area in which Humana has a panel of Contracted Dentists.
- Your unmarried children up to age 19 or age 26* if a full-time student and dependent upon you for support;
- Your children who are incapable of self-sustaining employment due to developmental disability or physical handicap and who depend on you for their support and maintenance. You must furnish Humana with proof of dependent status, as provided by law.
(*limiting age may vary based upon state of residence)
As long as you meet the plan’s general eligibility requirements and pay the applicable premium, your acceptance is automatic.
P.O. Box 14283
Lexington, KY 40512-4283
Disclaimers and Disclosures:
This website provides a very brief description of some of the important features of this plan. It is not the insurance contract, nor does it represent the insurance contract. A full description of benefits, exclusions and limitations is contained in the Schedule of Benefits and your policy.
Rates shown are based upon the information you provided, and are subject to change based on the dental and/or vision plan's underwriting practices and your selection of available optional benefits, if any. Final rates and effective dates are subject to underwriting and are always determined by the dental insurance and/or vision insurance company. To be considered for reimbursement, expenses must qualify as covered expenses.
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