Here's an overview of the covered services for this plan:
- Preventive services - Oral examinations, X-rays, cleanings, topical fluoride treatment (through age 14, one per calendar year), and sealants (through age 14)
- Basic services - Emergency care for pain relief, nonsurgical extractions, and fillings (amalgams, composite for front teeth)
In addition, you may receive a discount on the following services if you see an in-network dentist.* These services are not covered under this plan. Out-of-pocket expenses for these services don't apply to deductible and annual maximum.
- Basic services - Space maintainers (through age 14), appliances for children, and prefabricated stainless steel crowns
- Major services - Crowns, inlays and onlays, bridgework, dentures, denture relines and rebases, denture repair and adjustments, oral surgery, periodontics (gum therapy), and endodontics (root canals)
- Orthodontia services - Adult and child orthodontia
Deductibles and coverage amounts vary by plan. To see your specific plan benefit details, log in to MyHumana. Be sure to review your plan certificate for important plan information such as deductibles or required waiting periods.
*Not applicable in the state of Georgia.
