humana dental prepaid hs205 plan

No copay No waiting periods,

* The above copayments do not include the additional cost of precious (high noble) per quadrant, Removal of benign odontogenic cyst or tumor—up to 1.25 cm, Removal of benign odontogenic cyst or tumor—greater than 1.25 cm, Removal of lateral exostosis (maxilla or mandible), Incision and drainage of abscess—intraoral soft tissue, Replace missing or broken teeth—complete denture (each tooth), Replace all teeth and acrylic framework—maxillary, Replace all teeth and acrylic framework—mandibular, Reline complete maxillary denture (chairside), Reline complete mandibular denture (chairside), Reline maxillary partial denture (chairside), Reline mandibular partial denture (chairside), Reline complete maxillary denture (laboratory), Reline complete mandibular denture (laboratory), Reline maxillary partial denture (laboratory), Reline mandibular partial denture (laboratory), Pontic—resin with predominantly base metal, Retainer—cast metal, resin bonded fixed prosthesis, Retainer—porcelain/ceramic, resin bonded fixed prosthesis, Inlay—cast high noble metal, two surfaces, Inlay—cast high noble metal, three or more surfaces, Inlay—cast predominantly base metal, two surfaces, Inlay—cast predominantly base metal, three or more surfaces, Inlay—cast noble metal, three or more surfaces, Onlay—porcelain/ceramic, three or more surfaces, Onlay—cast high noble metal, two surfaces, Onlay—cast high noble metal, three or more surfaces, Onlay—cast predominantly base metal, two surfaces, Onlay—cast predominantly base metal, three or more surfaces, Onlay—cast noble metal, three or more surfaces.

Note: Limitations and exclusions may apply. Offered or administered by HumanaDental Insurance Company, the Dental Concern, Inc., Copyright 2019 Bloom Insurance LLC; in California by S. Rogers' Insurance Agency LLC. Prophylaxis (routine cleanings) – two per calendar year, Topical fluoride application (up to age 16) – two per calendar year, Topical fluoride application (adult) – two per calendar year, by primary care dentist, Bitewing X-rays (up to a set of four) – two per calendar year, Full-mouth X-rays (panoramic film) – once per three calendar years. The HD205 Prepaid Plan focuses on maintaining oral health, prevention and cost containment. CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., conscious sedation—first 30 minutes (limited to the removal of partial, or Humana legal entities that offer, underwrite, administer or insure insurance products and services, View a complete list of the legal entities. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). Please enter the age and zip code of the primary policy holder, and we will check availability of this plan in your area and calculate the plan costs for you and your family. Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state. conscious sedation—additional 15 minutes (limited to the removal of partial,

notice, per 15 min) —maximum $40 per broken Texas residents insured by Humana … of age) (two per calendar year), Topical application of fluoride—adult (two per calendar year, by primary care dentist), Topical fluoride varnish (for child <16) (two per calendar year), Nutrition counseling for the control or avoidance of dental disease, Tobacco counseling services for the control or prevention of oral disease, Sealant—per tooth (permanent teeth only to age 16), Space maintainer—fixed, unilateral (through age 14), Space maintainer—fixed, bilateral (through age 14), Space maintainer—removable, unilateral (through age 14), Space maintainer—removable, bilateral (through age 14), Amalgam—one surface, primary or permanent, Amalgam—two surfaces, primary or permanent, Amalgam—three surfaces, primary or permanent. With in-network providers, 100% covered Office visit (after regularly scheduled hours). Check to see if your current dentist is in our network.

“Humana” is the brand name for plans, products and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). The HD plan … HumanaDental Prepaid HS205 Plan. Humana individual vision plans are insured by Humana Insurance Company, The Dental Concern, Inc., or Humana Insurance Company of New York, or Humana Health Benefit Plan of Louisiana, Inc. Arizona residents insured by Humana Insurance Company. With in-network providers, Cleanings exceed $125 per unit and $75 per unit for semi-precious metal.. Our dental plans and vision plans may also have waiting periods. 100% covered Whether you simply need quality routine dental .

In the event of a dispute, the policy as written in English is considered the controlling authority.

Humana individual vision plans are insured by Humana Insurance Company, The Dental Concern, Inc., or Humana Insurance Company of New York, or Humana Health Benefit Plan of Louisiana, Inc. Arizona residents insured by Humana Insurance Company. Amalgam—four or more surfaces, primary or permanent.

100% covered (no deductible) The additional cost of precious metal shall not FL52374HD 0117 Page 1 ... available at Disclosure.Humana.com. With in-network providers, X-rays Limitations and exclusions may apply. Whether you need routine care or a major dental procedure, you know what to expect from HumanaOne Dental Value Plan.

Resin based composite—one surface, anterior, Resin based composite—two surfaces, anterior, Resin based composite—three surfaces, anterior, Resin based composite—four or more surfaces or involving incisal angle (anterior), Resin based composite—one surface, posterior, Resin based composite—two surfaces, posterior, Resin based composite—three surfaces, posterior, Resin based composite—four or more surfaces, posterior, Inlay—porcelain/ceramic, three or more surfaces, Onlay—porcelain/ceramic, four or more surfaces, Inlay—resin based composite, two surfaces, Inlay—resin based composite, three or more surfaces, Onlay—resin based composite, two surfaces, Onlay—resin based composite, three surfaces, Onlay—resin based composite, four or more surfaces, Crown—3/4 resin based composite, indirect, Crown—resin with predominantly base metal, Crown—porcelain fused to high noble metal, Crown—porcelain fused to predominantly base metal, Recement cast or prefabricated post and core, Prefabricated stainless steel crown—primary tooth, Prefabricated stainless steel crown—permanent tooth, Prefabricated stainless steel crown with resin window, Prefabricated esthetic coated stainless steel crown—primary tooth, Pin retention—per tooth, in addition to restoration, Prefabricated post and core in addition to crown, Each additional prefabricated post—same tooth, base metal post, Labial veneer (resin laminate)—laboratory, Labial veneer (porcelain laminate)—laboratory, Additional procedure—new crown existing partial denture, Cast post and core, in addition to fixed partial denture retainer, Prefabricated post and core in addition to fixed partial denture retainer, base

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