Dental Insurance
Dental DHMO plans are like health HMOs. All services must be obtained from a participating dentist or specialist. No referral is needed for specialty services. Members are required to select a Primary Care Dentist (PCD)/Facility or Humana/CompBenefits will auto-assign one. Each family member can select a different PCD/Facility. PCD’s can be changed on a monthly basis, however, the change must be made by the 15th of the month to be effective the 1st of the following month. Dental services are based on a Discounted Fee Schedule (see complete schedule in Humana/CompBenefits booklet). The Discounted Fee Schedule applies to services provided by your primary dentist and specialists.
Note: not all ADA (American Dental Assoc.) codes are covered under the DHMO plan. Services received for ADA codes not covered under the Discounted Fee Schedule are provided at a 25% discount. This plan does not include a “Missing Tooth” exclusion. See Humana/CompBenefits material for more details.
2013 DHMO Plan Rates
(Deductions for Domestic Partner and/or Over Age Dependent (Child age 26-29 on 01/01/12) coverage will be split between pre- and after-tax deductions).
|
TIER |
DHMO CS150P |
|
Employee |
$5.70 |
|
Emp+Spouse/DP |
$10.26 |
|
Emp+Child |
$11.40 |
|
Emp+Family |
$13.68 |
Contact Information
Member Services, 800-979-4758
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