Frequently Asked Questions

Dental Value Plan HI215-TX

Q: How many times a year can I have my teeth cleaned?
Routine cleanings are covered at your selected network primary care dentist two times per calendar year.
Q: What is a pre-existing condition? Is it covered?
A pre-existing condition is any dental or oral health condition, which existed before joining the plan. There are no exclusions for pre-existing dental conditions.
Q: What is work in progress? Is it covered?
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.
Q: Are cosmetic procedures discounted? If so, what procedures?
Yes. Cosmetic procedures are available from a HumanaOne dentist at a 25% discount from the usual fee.
Q: Is Orthodontia Covered? What are the Orthodontia benefits? If yes, is Invisalign braces covered?
Should you need a Specialist, (i.e., Orthodontist), you may be referred by your Participating General Dentist, or you may refer yourself to any Participating Specialist. Upon identification of yourself as a HumanaOne member, you will receive a 25% reduction from usual and customary fees for services performed. Specialist services are available only in areas where the dental plan has a Participating Specialist.
Q: Do I need to obtain claim forms?
No. There is no need to obtain claim forms.
Q: Is there a waiting period?
There are no waiting periods on this plan. You may start using your benefits as soon as you become effective
Q: Is this insurance?
The Dental Value Plan HI215 is a prepaid dental plan, which is commonly referred to as a Dental HMO (DHMO).
Q: Can I change my dentist once I am in the plan?
Yes. You can easily change dental offices by calling Member Services.
Q: My dentist isn’t currently in the directory. What can I do?
We welcome nominations for dental providers. Please contact Member Services with your nominations.
Q: How long does it take to process my application?
Application processing times may vary based upon type of payment received.
Q: When will I receive my enrollment package and what will it include?
Enrollment packages are sent out shortly after the application has been processed. The enrollment package will include the Certificate of Coverage, Schedule of Benefits and ID card.
Q: If I choose to pay by credit card, what will my credit card statement read?
HumanaOne Dental and Vision.
Q: If I choose to pay by Bank Account Draft (ACH), what will my bank statement read?
HumanaOne Dental and Vision.
Q: Is the processing fee billed separately or with the premium?
For your convenience, your one time processing fee is billed with your premium.
Q: Can I change my payment type once I am in the plan?
Yes, you may change your payment type at any time by calling Member Services.
Q: If I started with monthly payment, can I change it to annual payment at a later date?
Yes, you may change to annual payments by calling Member Services.
Q: Do the applicant name and the billing name need to be the same?
No, the applicant name and the billing name do not need to be the same.
Q: What if I need to change my membership from Individual to Family Coverage?
Please contact HumanaOne Member Services to add any family members to the plan.
Q: How do I add or cancel coverage for a dependent?
Please contact Member Services and they will assist in adding or canceling your membership for additional members.
Q: If I cancel the policy, will I receive a refund of the premium or processing fee?
Your one time processing fee is non-refundable.