DENTAL PLANS

Humana State of Texas Dental Choice

Humana DHMO

Dental Choice Plan

Dental Plan

Premiums (Monthly)

Employee Only

 $13.94

 $ 0.00

Employee/Spouse

 $36.40

 $ 8.53

Employee/Children

 $45.38

 $11.93

Employee/Family

 $67.84

 $20.46

Physician Choice

Your Choice. There is a network of dentists available.

Plan Providers

Preventative Cost

Network Dentist: $0; Non-Network Dentist: $50 deductible/10% coinsurance

$12 copay

Restorative Cost

Basic & Major Services-Network - $50 deductible/10% coinsurance for basic/50% coinsurance for major.

Copayment Schedule

Major Restorative Cost

Basic & Major Services-Network - $50 deductible/10% coinsurance for basic/50% coinsurance for major.

Copayment Schedule

Maximum Annual Benefit

$1500 per covered individual (excludes orthodontia services)

No Maximum