State of Texas Dental Choice PlanSM
HumanaDental's PPO plan is supported by our professional, caring experts.
Please be sure to select the PPO/Traditional Preferred network when searching for a provider online.
Common questions
May I go to any dentist?
Yes; however, for maximum benefits at the lowest cost, visit a participating PPO network dentist.
If you want to suggest a provider to be added to the network, please call (877) 377-0987 or use the Provider nomination form.
What's the benefit of seeing a participating PPO network dentist?
If your dentist is not in the network, you still receive benefits, but you'll pay higher out-of-pocket costs for the dental services, such as deductibles.
Please be sure to select the PPO/Traditional Preferred network when searching for a provider online. To verify if a dentist participates in the Network, visit our Dentist Finder or call Customer Service at (877) 377-0987
What if they visit a non-network dentist?
If you choose to visit a non-network dentist, your services are subject to the non-network benefit level and charges are subject to a maximum allowable charge. If a participating dental provider is used, a lower coinsurance will be paid by the participant.
What is the billing process?
- Prior to receiving services, review your plan certificate for important plan information, such as deductibles.
- When you visit a participating network dentist, simply present your HumanaDental identification card.
- The dentist will submit the claim to us on your behalf.
- HumanaDental will review the claim and reimburse the dentist for eligible charges.
- HumanaDental will mail an Explanation of Benefits (EOB) to your home. Your dentist will bill you for your portion of the charges. If you visit a participating PPO network dentist, your dentist cannot bill you for amounts over the negotiated fees, ensuring lower out-of-pocket costs for you. You pay your dentist directly, if applicable.
- To determine what will be paid on a procedure, have your dentist submit a pretreatment estimate. We do not preauthorize benefits over the phone.
How do I file an appeal?
You can learn more about the appeal process online
What if I am no longer qualified to continue coverage?
When a participant is no longer eligible to continue coverage under the State of Texas Dental Choice PlanSM because COBRA continuation of coverage ends, the participant is eligible to apply for a HumanaOne individual dental plan.
To be eligible, the participant, or their qualified dependents, must apply within 31 days after the last day of coverage. However, the participant may apply for the conversion policy prior to the end of coverage under the State of Texas Dental Choice PlanSM. If issued, the HumanaOne individual dental plan will go into effect the first of the month following approval. If you have any questions about your conversion privilege or need an application, please call (877) 377-0987.
