Humana Dental DHMO High

The Humana Dental DHMO High Plan helps members manage dental care costs with no annual maximums, no deductibles, and no waiting periods. Many diagnostic and preventive services are covered at no charge, while other covered services require a fixed copayment.

DHMO Comparison Chart

To receive benefits, members should use their selected participating in-network dentist (primary care dentist or PCD). In general, services from non-participating dentists are not covered unless allowed under emergency care provisions or otherwise authorized by the plan. Procedures not listed in the copayment schedule are not covered.

Members may access participating specialists by referral from a general dentist or by self-referral, and covered specialist services are subject to the listed copayment. Some procedures marked with an asterisk (*) also include additional laboratory or material fees.

Summary of Benefits

If differences exist between this Summary of Benefits and your Certificate of Coverage/benefits administrator, the certificate/benefits administrator will govern.

Plan Documents & Resources

Exclusions & Limitations

Some copays do not include the cost of material and laboratory fees.  Review the plan summary for additional details.

If services for a listed procedure are performed by the Contract Dentist, you pay the specified copayment. During the course of treatment, your Contract Dentist may recommend the services of a dental specialist. Your Contract Dentist may refer you directly to a Contract Specialist; referral approval from us is not required. However, certain procedures my require pre-treatment authorization prior to care. You pay the copayment specified for such services.

Teledentistry services provided by a Dentist other than your Contract Dentist are considered Out-of-Network and my result in an out-of-pocket cost to you.

NOTE:

  • Not all participating dentists perform all listed procedures, including amalgams. Please consult your dentist prior to treatment for availability of services.
  • When crown and/or bridgework exceeds six units in the same treatment plan, the patient may be charged an additional $30 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. If you do not have a certificate of benefits, please review the Specialty Benefits Regulatory and Technical Information Guide available at Humana.com/insurance-through-employer/enrollment-center/pre-enrollment-disclosure.

Offered by CompBenefits Company.

This communication provides a general description of certain identified insurance or non-insurance benefits provided under one or more of our insurance benefit plans. Our insurance benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, refer to the plan document or call or write your Humana insurance agent or the company. In the event of any disagreement between this communication and the plan document, the plan document will control.

Customer Service Hotline (prior to your effective date):

1-855-811-0409
Monday to Friday, 8 AM to 6 PM

Member Services (after to your effective date):

1-800-233-4013
Monday to Friday, 8 AM to 6 PM

Website:

www.humana.com (prior to your effective date)
www.myhumana.com (after your effective date)

Service Hours (EST):

M-F: 8:00am – 6:00pm