Humana
Humana Extend 2500
This individual Humana Extend dental, vision, and hearing plan is designed for people who are looking to combine their coverages into a single plan while maximizing their benefits. This plan offers access to a nationwide network of providers who specialize in routine dental, vision, and hearing services. Coverage includes preventive, basic, and major dental services, in addition to vision and hearing services.
| Common procedures: | |
|---|---|
| Cleaning: | 100% |
| White Filling: | 80% |
| Crown: | 50% |
| Root Canals: | 50% |
| Simple Extractions: | 80% |
| Plan Maximum: | $2500 per calendar year, per insured person for Dental Preventive, Basic and Major services $1000 per person, Dental Implant annual maximum $2000 per person, Dental Implant lifetime maximum |
| Waiting Periods: | Preventive-None, Basic-90 days, Major-12 months |
| Deductible: | $75 per person for Preventive, Basic and Major Services. Deductible waived for in-network preventive services |
| Vision Care Services In Network: Routine exam: $10 copay Rx Glasses: $25 copay Frame: $100 Allowance Contacts (instead of glasses): $100 Allowance Vision Provider Search Hearing Coverage through TruHearing (hearing coverage not available in NY) Hearing Exam: $0 copay Advanced level hearing aid: $699 copay per ear You must see a TruHearing® provider to use this benefit. Call 855-241-6293 to schedule an appointment (for TTY, dial 711). You will have access to over 7,000 provider locations in the TruHearing network. Visit TruHearing.com for more information. For more details on Vision and Hearing benefits, please see Plan Brochure | |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine periodic examinations – twice in a calendar year In Network – 100% Out of Network – 100% after deductible Preventive – No waiting period | Cleanings: |
| Cleanings: twice in a calendar year In Network – 100% Out of Network – 100% after deductible Preventive – No waiting period | X-Rays: |
| Radiography: Bitewing x-rays (limit one set of two films every calendar year for ages 10 and younger, and limit one set of four films every calendar year for ages 11 and older) and Panoramic (one in 5 calendar years) In Network – 100% Out of Network – 100% after deductible Preventive – No waiting period | Fillings: |
| Fillings: Restorative Amalgam Fillings (limit one per tooth per two calendar years)
Resin-based composite (white fillings) anterior only In Network – 80% after deductible Out of Network – 80% after deductible Basic – 90 days waiting period | Extractions: |
| Simple extractions and root removal: In Network – 80% after deductible Out of Network – 80% after deductible Basic – 90 days waiting period | Crowns: |
| Crowns, inlays and onlays (limit once per tooth every five calendar years) In Network – 50% after deductible Out of Network – 50% after deductible Major – 12 months waiting period | Root Canals: |
| Endodontics: Pulpal therapy and root canals (limit one per tooth per lifetime) In Network – 50% after deductible Out of Network – 50% after deductible Major – 12 months waiting period | Dentures: |
| Complete dentures (limit one every five calendar years) Denture repair and adjustments (if more than six months after initial placement) In Network – 50% after deductible Out of Network – 50% after deductible Major – 12 months waiting period | Deep Cleanings: |
| Treatment of diseases of the gums In Network – 50% after deductible Out of Network – 50% after deductible Major – 12 months waiting period | Implants: |
| Dental implant-surgical placement (One per tooth per five years, subject to review) In Network – 50% after deductible Out of Network – 50% after deductible Major – 12 months waiting period (applies for all dental implant services and cannot be waived) | Braces/Orthodontia: |
| Not Covered Service | Teeth Whitening: |
| External bleaching – per arch – performed in office $100 allowance, does not apply to deductible or annual dental maximum. No waiting period. | Additional Network Information: |
Good oral health means more than an attractive smile. Research shows that oral health, preventive care and regular visits to the dentist are integral to overall health. You can lower your cost by choosing one of the more than 325,000 dentist locations in the Humana Dental network. You can use Dentist Search to find a participating specialist. Out-of-network dentists can bill you for charges above the amount covered by your Humana Dental plan. To ensure you do not receive additional charges, visit a dentist in the Humana Dental PPO Network. Waiting periods and other limitations may apply; please see your policy for coverage details. This plan may require a one-year contract. Exclusions and LimitationsPrivacy Policy Plan Brochure |
FAQ:
Can I change my dental/vision provider once I am in the plan?
Yes. You can change dentist or dental office at any time. Please contact Member Services for help locating participating provider in your area.
What is a pre-existing condition versus work-in-progress? Is it covered?
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?
Dental: You can lower your cost by choosing one of the more than 325,000 dentist locations in the Humana Dental network. You can use Dentist Search to find a participating specialist.
You can visit an in-network or out-of-network dentist, with the same coverage for services. Out-of-network dentists can bill you for charges above the amount covered by your Humana Dental plan.Vision: You have access to one of the largest vision networks in the United States, with optometrists and ophthalmologists at more than 125,000 access points, including both independent and national retail locations such as LensCrafters®, Pearle Vision®, and Target Optical®. In addition you’ll enjoy the same benefits at all participating providers, no matter where they're located.
Hearing: You will have access to over 7,000 provider locations in the TruHearing network. Visit TruHearing.com for more information.
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 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.
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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