Administered by HumanaDental.
To receive plan benefits, you must select and use a primary care dentist (PCD) from the DHMO Dentist Finder on the HumanaDental website.
Must choose a network dentist to receive covered benefits.
You do not have to file claims for the HumanaDental DHMO, except for out-of-area emergency care. HumanaDental pays your dentist directly.
You can appeal a decision with a Texas Employees Group Benefits Program (GBP) insurance carrier. Additional guidelines are provided in writing to members during the appeals process.
Administered by HumanaDental.
Choose any dentist. You will receive higher benefits if using a participating dentist through the preferred provider network.
You pay nothing for diagnostic and preventive services.
You pay 10% of allowed amount for preventive services up to maximum benefit after deductible is met.
0% - Two (2) cleanings/oral exams per calendar year are covered at 100%.
10% of the allowed amount after deductible is met. Two (2) cleanings/oral exams per calendar year are allowed.
Orthodontic services are only available to dependents age 19 or younger. Orthodontic benefits are available to dependents age 19 or younger, Humana will allow 50% of the covered orthodontia services, up to: the lifetime maximum.
Orthodontic services are only available to dependents age 19 or younger. Humana will allow 50% of the covered orthodontia services, up to the lifetime maximum. You may be required to pay the difference between the allowed amount and billed charges.
Note: If you are a State of Texas Dental Choice PlanSM (PPO) participant, any covered dental expenses that applied to your deductible during the last three months (October-December) of the calendar year will apply to your deductible in the new calendar year. This means you don't have to satisfy a deductible at the end of one year and a deductible at the start of another year.
Claims should be filed within 90 days of the date of service. The State of Texas Dental Choice PlanSM will not accept a claim submitted later than 18 months after the expenses were incurred or date of service. Send copies of your provider’s itemized bill to file your claim. Special claim forms are not required.
You can appeal a decision with a Texas Employees Group Benefits Program (GBP) insurance carrier. Additional guidelines are provided in writing to members during the appeals process. More information about the appeals process.
Administered by Careington.
Under this plan, participating dentists have agreed to accept a discounted fee from participants as payment-in-full for dental services performed.
Benefits-eligible employees, retirees, and
dependents can enroll in the plan as a new employee, a new retiree, within 31
days of a qualifying life event and during Annual Enrollment. Plan advantages
Review the frequently asked questions about the State of Texas Dental Discount Plan>
200 East 18th Street Austin, TX 78701 ( map)
Toll Free (877) 275-4377
Relay Texas, TTY 7-1-1 or (800) 735-2989