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Access My Account

HumanaDental DHMO Coverage

Administered by HumanaDental.
To receive plan benefits, you must select and use a primary care dentist (PCD) from the DHMO Dentist Finder.

Must choose a network dentist to receive covered benefits.

◾ Deductible - $0
◾ Copays - Costs vary based on service provided (including cleanings and oral exams). See the Dental Care Sc
on the HumanaDental website.
◾ Maximum benefit - Unlimited per calendar year / unlimited lifetime.
◾ Cleanings/Exams - Varies according to service. Allows 2 exams per calendar year at no cost and 2 cleanings
year with $12 copay.
◾ Orthodontic - Services performed by a general dentist listed in the directory – child - $1,800, adult - $2,100; s
performed by specialist – You pay 75% of his/her usual fee. DHMO pays nothing.
◾ Specialty dentistry - You are responsible for 100%; however, the PCD will charge only 75% of his or her usu
for specialty dentistry. Orthodontic services preformed by a specialist are covered at this level.

Filing Claims

You do not have to file claims for the HumanaDental DHMO, except for out-of-area emergency care. HumanaDental
your dentist directly.

You can appeal a decision with a Texas Employees Group Benefits Program (GBP) insurance carrier. Additional guid
are provided in writing to members during the appeals process. More information about the appeals process.

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