and semi-precious (noble) metal. 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.
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
With in-network providers, X-rays Association membership and fees may be required in some states. With in-network providers, Discounted 20-40% on average None for in-network preventive services, otherwise: Cleanings Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. All rights reserved. d/b/a CompBenefits. The HumanaOne Dental Value Plan HI215 plan is affordable, dependable coverage that helps you get the dental treatment you need, when you need it. Note: Limitations and exclusions may apply. • No waiting periods • No claims to file • No annual maximums. The HD205 Prepaid Plan focuses on maintaining oral health, prevention and cost containment. No copay
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