Humana
Dental Value Plan HI215

The Humana Dental Value Plan HI215 plan has you covered for any circumstance. Whether you simply need quality routine dental care or unexpected dental treatment, you know what to expect with Humana dental. You have a network of more than 5,000 participating dentists nationwide. You must select your dentist before you enroll but can change participating dentists at any time. Even though you have the option of paying monthly or yearly, this is a one year plan.

Here’s what you can expect:

You have the freedom to select any participating general dentist as your primary care dentist
Life without claim forms! With the Humana Dental Value Plan HI215 plan you pay your dentist directly, when applicable
Your primary care dentist will provide all of your routine dental care and any copayment or discounted charges will be paid at the time of service
If you need a specialty dentist, you may receive a 25 percent discount by using one of the participating specialty dentists from our network

The Humana Dental Value Plan HI215 plan enables you to take better care of your teeth, and you may pay less doing so:

100% coverage for many preventive procedure
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 at participating specialty dentist from Humana network
For any procedure not specifically listed, you may receive a discount off the participating primary care dentist’s usual fees
No deductibles
No claims to file
No waiting periods
No benefit maximums

Common procedures:
Cleaning:	No charge
White Filling:	From $45
Crown:	$410*
Root Canals:	From $175
Simple Extractions:	$55
Plan Maximum:	None
Waiting Periods:	None
Deductible:	None

Details:
Fee Schedule \| Dentist Search
Exams:
No charge for Periodic oral examination (2 per calendar year)
Cleanings:
No charge for basic cleaning (2 per calendar year, by primary care dentist)
X-Rays:
No charge. See Fee Schedule for limitations and details
Fillings:
Member pays: $30 for Amalgam filling-one surface, primary or permanent $45 for (white filling) Resin based composite-one surface, anterior $70 for Resin based composite-one surface, posterior
Extractions:
Member pays: $55 for (Simple) Extraction, erupted tooth or exposed tooth
Crowns:
$410* for crown-porcelain fused to noble metal
Root Canals:
Member pays: $175 for Root canal therapy-anterior (excluding final restoration) $390 for Root canal therapy-molar (excluding final restoration)
Dentures:
Member pays: $550* for complete denture (maxillary); $550* for complete denture (mandibular)
Deep Cleanings:
Member pays: $70 for Periodontal maintenance (covered only after active periodontal therapy)
Implants:
Not available
Braces/Orthodontia:
Discounts may be available with in-network orthodontis
Teeth Whitening:
Not available
Additional Network Information:
Under our Dental Value Plan HI215, you must select a primary dentist from the Humana 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 Dental Value Plan HI215. 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 Privacy Policy Plan Brochure
Notes:
The laboratory charges must be paid to the plan dentist in addition to any applicable copayment for the service. Members can receive a 25 percent savings by visiting an in-network orthodontist. Not all participating dentists perform all listed procedures, including amalgams. Please consult your dentist prior to treatment for availability of services. Unlisted procedures are at the participating dentist’s usual fee less 25%. When crown and/or bridgework exceeds six units in the same treatment plan, the patient may be charged an additional $75 per unit. Some covered services are typically only offered by a specialist (like many oral surgery procedures). Additional exclusions and limitations are listed along with full plan information in your certificate of benefits.

FAQ:

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 Humana Member Account Portal

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.

Dependents are:

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.

Humana Specialty Benefits
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.

This site was designed to provide you with a general description of the plans you requested. Keep in mind that it does not include all the benefits and limitations outlined in the policies -- it is the insurance contract, not the general descriptions on this website, which forms the contract between you and the insurance company.

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