Your Dental Benefits
A great smile opens hearts and doors and makes the important work we do a lot easier! And good oral health is important for our overall health. According to the Academy of General Dentistry, there is a link between gum disease and heart problems, and according to the American Academy of Periodontology, severe gum disease can increase blood sugar, increasing the risk for diabetics.
That's why the Texas Annual Conference of the United Methodist Church (TAC) is offering two comprehensive dental plans, allowing you to choose the plan that best fits the needs of you and your family. Enrollment is optional and the clergy or lay employee pays the entire cost of coverage (no employer contribution).
Both plans have no annual deductible and provide preventive care every six months (cleaning, exams and x-rays) at no charge.
Who is eligible?
- Active clergy and TAC Fiscal Office lay employee participants in the Group Health medical plan and their eligible dependents. Eligible dependents may participate in an optional dental plan regardless of whether or not they are enrolled in the medical plan.
- Retired clergy and their eligible dependents who are enrolled at the time of the clergy's retirement may continue to participate in either the dental HMO or dental PPO plan. Once retired clergy or their enrolled dependents terminate coverage in a dental plan, they are not eligible to re-enroll in any dental plan at a future date. Retired clergy and their enrolled dependents may switch between the dental HMO and dental PPO plans by completing an enrollment form during their annual Open Enrollment Period, October 15 – 31. Plan changes take effect on January 1 of the following year.
How the dental plans work
- The dental PPO has an extensive list of in-network providers, including primary care and specialty dentists. You're covered regardless of what dentist you use, although you'll pay less for a participating one.
- You're covered up to $1,500 a year in benefits per participant.
- There is an additional $1,500 lifetime orthodontia maximum benefit per participant following a 12-month waiting period. The waiting period may be reduced or waived for prior orthodontic coverage.
- There's no charge for preventive care. You pay a percentage (co-insurance) for other services (see a list of covered services).
- The dental HMO requires you to select a participating primary care dentist and receive all primary care from that dentist in order to receive benefits. The plan pays no benefits if you go to a non-participating dentist. Certain locations in the TAC may have limited or no access to participating dental HMO (DHMO) providers, so check for providers in your area if you are interested in enrolling.
- You must pre-select and identify a participating dentist (with the dentist's ID number and address) on your enrollment form in order to enroll in the dental HMO. Your coverage is not effective until you have a participating primary care dentist indicated on your ID card.
- After enrollment, you can change your primary care dentist at any time, but you need to allow 4 to 6 weeks for the change to take effect.
- If you are enrolling your children in the dental HMO, check with the primary care dentist you are selecting in advance to verify if the dentist treats children and at what ages.
- If you need a specialty dentist, you'll receive a 25% discount by using an in-network specialist. Specialty dentists are very limited in the dental HMO, so if you or your family members need a lot of specialist care, the dental PPO may be a better option for you.
- There is no limit to the number of visits per year (preventive care is covered every six months).
- There is no annual maximum limit to benefits.
- There's no charge for preventive care. You pay a $5 office visit fee per visit and a co-pay for other services (see a list of covered services).
|Dental PPO||Dental HMO|
|How much does it cost?|
|Employee||Employee & Spouse||Employee & Children||Employee & Family||Employee||Employee & Spouse||Employee & Children||Employee & Family|
|Can I go to any dentist?|
|Yes, but pay less for in-network
||No, primary care benefits are only available from the participating dentist specified on your ID card.|
|Is orthodontia covered?|
|Yes (with a 12-month waiting period)||Yes|
|Is there a deductible?|
|How much will it cover?|
|$1,500 a year||Unlimited|
|Is preventive care covered?|
|Yes, at 100% (every 6 months)|
|How are benefits paid?|
|Percentage-based or allowance||Co-pay|
|Have a question?|
Find a dentist
Need a dentist? It's easy to find one. To find a participating dentist in either dental plan:
- Go to www.humana.com, scroll to the right side of the middle of the page, and under “Find a doctor or pharmacy,” click the green “Search” button.
- On the next page at the top under “Find a doctor or pharmacy,” in the “Search type” box, use the drop-down menu to select “Dental.” Then click the green “Go” button.
- Under “Search by Humana plan or member ID,” click on the tab “Just looking” if you don’t know or don’t have a member ID number.
- In box 1, “Coverage type,” select either the DHMO or PPO option depending on which plan you are interested in.
- In box 2, enter your zip code.
- In box 3, “Network,” use the drop-down menu to choose “HD DHMO Prepaid C250” for the dental HMO or “PPO/Traditional Preferred” for the dental PPO.
- In box 4, “Search,” use the drop-down menu to select “Name” and enter the dentist’s name if you have a particular dentist you are looking for. Otherwise, select “Specialty” and underneath the box to the right, click on the blue specialty link in the phrase: Enter a specialty. A list of specialties will come up. Select the specialty you are interested in or select “Dentistry” if looking for a primary care dentist.
- Click the green “Search” button.
- You can refine your location by adjusting the radius of your search.
Questions? Call the TAC Benefits Office at 1-800-606-0350.
Want to know more?
- Read the details about the dental PPO plan
- Read the details about the dental HMO plan
- Visit the HumanaDental website
- If you have questions...