Humana
Preventive Plus
If you’re looking for a dental PPO plan, this one is low-cost and provides coverage for preventive and basic care, such as cleanings , X-rays, fillings and extractions. Plus, there are no copayments for office visits.
Here’s what you can expect:
- Freedom to visit any dentist you like
- Most in-network preventive services covered 100%
- Additional discounts may be available for visiting network dentists
| Common procedures: | |
|---|---|
| Cleaning: | 100% |
| White Filling: | 50% |
| Crown: | Discount Services* |
| Root Canals: | Discount Services* |
| Simple Extractions: | 50% |
| Plan Maximum: | $1000 per calendar year, per individual on the plan |
| Waiting Periods: | Preventive-None, Basic-6 months, Major-None-Discount Services* |
| Deductible: | $50 per calendar year, per individual on the plan up to a maximum of $150 per family |
| Details: |
|---|
| Fee Schedule: N/A | Dentist Search | Exams: |
| Routine oral examinations (limit two per year) In Network – 100% – no deductible Out of Network – 70% of in network fee schedule after deductible No waiting period | Cleanings: |
| Cleanings (limit two per year) In Network – 100% – no deductible Out of Network – 70% of in network fee schedule after deductible No waiting period | X-Rays: |
| Bitewing X-rays (limit one set per year, excludes full mouth and panoramic) In Network – 100% – no deductible Out of Network – 70% of in network fee schedule after deductible No waiting period | Fillings: |
| Fillings (Limit two per year, composite covered on front teeth only*) In Network – 50% after deductible Out of Network – 30% of in network fee schedule after deductible 6-month waiting period applies | Extractions: |
| Extractions and root removal In Network – 50% after deductible Out of Network – 30% of in network fee schedule after deductible 6-month waiting period applies | Crowns: |
| Discount Services* | Root Canals: |
| Discount Services* | Dentures: |
| Discount Services* | Deep Cleanings: |
| Discount Services* | Implants: |
| Discount Services* | Braces/Orthodontia: |
| Discount Services* | Teeth Whitening: |
| Not Covered Service | Additional Network Information: |
Under our Preventive Plus dental plan, you can choose to visit any dentist from the Humana network, no primary care dentist required. There are more than 270,000 dentist locations on the Humana Dental PPO network. Simply present your Humana Dental identification (ID) card when you see your dentist. It contains all the information your dentist needs to submit your claims. 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 HumanaDental PPO network. Exclusions and Limitations: N/APrivacy Policy Plan Brochure | Notes: |
* Discount Services – You may receive a discount on these non-covered services. You may contact your participating provider to determine if any discounts are available on non-covered services. Out-of-pocket expenses do not apply to deductible and annual maximum. Members are responsible for 100% of the discounted service. |
FAQ:
Can I change my dentist 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?
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?
Under our dental plan, you can choose to visit any dentist from the Humana network, no primary care dentist required. There are more than 270,000 dentist locations on the Humana Dental PPO network. Simply present your Humana Dental identification (ID) card when you see your dentist. It contains all the information your dentist needs to submit your claims.
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.
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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