Humana is one of the leading health insurance brands in the United States. The company’s plans cover just about any medical area you may need treatment in—rest assured you are in great hands. That is, of course, whether you can find a doctor, dentist, or optometrist who accepts Humana insurance.
Dental and vision plans excluding Dental Savings Plus may have a minimum one-year initial contract period. Humana individual vision plans are insured by Humana Insurance Company, The Dental Concern, Inc., or Humana Insurance Company of New York, or Humana. Humana Dental is one of the nation’s largest and most trusted dental provider networks. Over 175,000 dentists made the choice to become in-network providers due to Humana’s commitment to high quality dental care, and agree to keep rates affordable for members and their families.
Many people have difficulties in finding dentists and other doctors that accept their brand of insurance without having to research for days. Luckily, there are now many easier options that have arisen with the boom of technology and the creation of the Internet.
Let’s talk about:
- Dental insurance plans covered under Humana
- How much these plans cost
- How to find a dentist that will accept your insurance plan for dental treatment
Dental Plans Covered Under Humana Insurance
There are five dental plans that you can purchase with Humana. You will decide based on the cost, the services covered, and what you think you may need. Here is a general overview of what you can expect from each plan. For a more comprehensive look after, visit Humana’s site.
(Why are we covering this? Because the health plan that you choose may affect where you can go for dental care based on your needs and price range.)
Humana Dental Value
This is the most basic plan that Humana offers in the dental category. All preventative services like X-rays and dental cleanings are covered after your copay, and you don’t have to wait. Basic services come at a discount and so do major services like root canals.
Humana Dental Loyalty Plus
With this plan, you have all the preventative services covered as well. Your basic and major services have coverage that goes up for each year that you are enrolled. There are also no waiting periods with in-network providers for this plan.
Humana Dental Preventative Plus
Like the former two plans, your preventative services will be covered after your copay. The basic and major services are discounted, but you have to meet a deductible to get 50% off on your basic needs.
Humana Dental Savings Plus
With this dental insurance plan, your preventative dental treatments are only covered in the range of 20–40%. While you have no waiting period for these services, you will be paying more per visit. The other two major services require no waiting period but the discounts on fees are more ambiguous.
Humana Complete Dental
Your preventative services under this plan are covered and your basic and major services are highly discounted after you pay a deductible. One notable fact about this plan is that there are waiting periods for the basic and major services that can be waived under certain circumstances.
Now that you have a basic idea of what the plans are and what they do cover, let’s talk about the cost of the plans themselves to adjust what you can expect from a dentist.
Costs of Humana Dental Plans
The tricky thing about the cost of health insurance plans is that they vary based on your personal health and dental problems and things like your age and location. You can, however, get a quote from them on what your insurance plan might cost.
How to Find a Dentist that Accepts Humana Insurance
Now that we have the basic facts out of the way and you know which insurance plan you have, you can begin to look for a dentist that accepts your Humana plan. There are a few different ways to do this, and all are much easier than you might have initially thought!
Call a Local Dentist
If you look online for a dental office that you know is in your area, chances are that you will find a number you can call to get in touch with their staff. Try it and ask the receptionist which brands of insurance are accepted by that office.
How to Get Started
- Download the “Google Maps” app on your smartphone. Type in “dentists” and you will likely get a list of locations with numbers to call.
- Do a quick Google search on your phone or PC browser. For example, type “dentists in my area.” If you have your location settings on, Google will accurately pinpoint offices near where you live or where you currently are.
Research Online
Some dental offices have websites that you can visit without having to call anyone until you need an appointment. On the site under a tab should be which forms of insurance they accept. Scroll down the list until you see Humana listed. If it isn’t there, it is likely that they don’t accept your dental plan.
How to Get Started
- Again, Google is your friend. Once you have used the “Maps” app or searched in your browser, the website and number should be listed on the same page that the locations are.
- Ask for a recommendation from a friend and search for that specific office’s site.
Visit Humana’s Website
Humana Dental Insurance Plans
The Humana website itself has several tools to guide you into the best experience possible. This includes a function called “Find a Dentist.” The offices listed on the page should be comprised of in-network providers that will accept your plan; from there, you can start calling for appointments!
Use Medical Help Resources
If none of the avenues you tried have worked, there are special sites and helplines that will find a dentist in your network and address any concerns or questions that they have the answers to. Here are the sites you should browse for help:
- Emergency Dentists USA. This site also has a “Find a Dentist” function. You enter your city or state into the search bar or click the hyperlinks given for each state. From there, you will have access to a comprehensive list of dentists to research and call.
Call the EDUSA toll-free number for help: 1 (888) 420-6826. (This is under the same hyperlink as the “Find a Dentist” button above.
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Humana Honor (PPO) H5216-235 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Humana available to residents in Tennessee. This plan does not provide additional Medicare prescription drug (Part-D) coverage. The Humana Honor (PPO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $3,400 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $3,400 out of pocket. This can be a extremely nice safety net.
Humana Honor (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of 'preferred' providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.
Humana works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Humana Honor (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Humana and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Humana except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
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2021 Humana Medicare Advantage Plan Costs
| Name: |
|---|
| Plan ID: | H5216-235 |
|---|
| Provider: | Humana |
|---|
| Year: | 2021 |
|---|
| Type: | Local PPO * |
|---|
| Monthly Premium C+D: | $0 |
|---|
| Part C Premium: |
|---|
| MOOP: | $3,400 |
|---|
| Similar Plan: | H5216-236 |
|---|
2021 Humana Honor (PPO) Summary of Benefits
Additional Benefits
Comprehensive Dental
| Diagnostic services | Not covered |
|---|
| Endodontics | $0 copay (Out-of-Network) |
|---|
| Endodontics | $0 copay |
|---|
| Extractions | $0 copay |
|---|
| Extractions | $0 copay (Out-of-Network) |
|---|
| Non-routine services | $0 copay (Out-of-Network) |
|---|
| Non-routine services | $0 copay |
|---|
| Periodontics | $0 copay |
|---|
| Periodontics | $0 copay (Out-of-Network) |
|---|
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay |
|---|
| Prosthodontics, other oral/maxillofacial surgery, other services | $0 copay (Out-of-Network) |
|---|
| Restorative services | $0 copay |
|---|
| Restorative services | $0 copay (Out-of-Network) |
|---|
Deductible
Diagnostic Tests and Procedures
Cost Of Humana Dental Plans
| Diagnostic radiology services (e.g., MRI) | 30% coinsurance (Out-of-Network) |
|---|
| Diagnostic radiology services (e.g., MRI) | $30-150 copay |
|---|
| Diagnostic tests and procedures | $0-50 copay |
|---|
| Diagnostic tests and procedures | $0 copay or 30% coinsurance (Out-of-Network) |
|---|
| Lab services | $0-40 copay |
|---|
| Lab services | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient x-rays | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient x-rays | $10-50 copay |
|---|
Doctor Visits
| Primary | 30% coinsurance per visit (Out-of-Network) |
|---|
| Primary | $10 copay per visit |
|---|
| Specialist | 30% coinsurance per visit (Out-of-Network) |
|---|
| Specialist | $30 copay per visit |
|---|
Emergency care/Urgent Care
| Emergency | $90 copay per visit (always covered) |
|---|
| Urgent care | $10-30 copay or 30% coinsurance per visit (always covered) |
|---|
Foot Care (podiatry services)
| Foot exams and treatment | 30% coinsurance (Out-of-Network) |
|---|
| Foot exams and treatment | $30 copay |
|---|
| Routine foot care | Not covered |
|---|
Ground Ambulance
| $290 copay (Out-of-Network) |
|---|
| $290 copay |
|---|
Hearing
| Fitting/evaluation | $0 copay (Out-of-Network) |
|---|
| Fitting/evaluation | $0 copay |
|---|
| Hearing aids | $399-699 copay |
|---|
| Hearing aids | $399-699 copay (Out-of-Network) |
|---|
| Hearing exam | 30% coinsurance (Out-of-Network) |
|---|
| Hearing exam | $30 copay |
|---|
Inpatient Hospital Coverage
| $550 per stay |
|---|
| 30% per stay (Out-of-Network) |
|---|
Medical Equipment/Supplies
| Diabetes supplies | 30% coinsurance per item (Out-of-Network) |
|---|
| Diabetes supplies | $0 copay or 10-20% coinsurance per item |
|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item (Out-of-Network) |
|---|
| Durable medical equipment (e.g., wheelchairs, oxygen) | 15% coinsurance per item |
|---|
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item |
|---|
| Prosthetics (e.g., braces, artificial limbs) | 30% coinsurance per item (Out-of-Network) |
|---|
Medicare Part B Drugs
| Chemotherapy | 20% coinsurance |
|---|
| Chemotherapy | 20-30% coinsurance (Out-of-Network) |
|---|
| Other Part B drugs | 20% coinsurance |
|---|
| Other Part B drugs | 20-30% coinsurance (Out-of-Network) |
|---|
Mental Health Services
| Inpatient hospital - psychiatric | 30% per stay (Out-of-Network) |
|---|
| Inpatient hospital - psychiatric | $550 per stay |
|---|
| Outpatient group therapy visit | $30 copay |
|---|
| Outpatient group therapy visit | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient group therapy visit with a psychiatrist | $30 copay |
|---|
| Outpatient group therapy visit with a psychiatrist | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient individual therapy visit | $30 copay |
|---|
| Outpatient individual therapy visit | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient individual therapy visit with a psychiatrist | 30% coinsurance (Out-of-Network) |
|---|
| Outpatient individual therapy visit with a psychiatrist | $30 copay |
|---|
MOOP
$5,100 In and Out-of-network
$3,400 In-network |
|---|
Option
Optional supplemental benefits
Outpatient Hospital Coverage
| $30-95 copay per visit |
|---|
| 30% coinsurance per visit (Out-of-Network) |
|---|
Preventive Care
| $0 copay or 30% coinsurance (Out-of-Network) |
|---|
| $0 copay |
|---|
Preventive Dental
| Cleaning | $0 copay |
|---|
| Cleaning | $0 copay (Out-of-Network) |
|---|
| Dental x-ray(s) | $0 copay (Out-of-Network) |
|---|
| Dental x-ray(s) | $0 copay |
|---|
| Fluoride treatment | $0 copay (Out-of-Network) |
|---|
| Fluoride treatment | $0 copay |
|---|
| Oral exam | $0 copay (Out-of-Network) |
|---|
| Oral exam | $0 copay |
|---|
Rehabilitation Services
| Occupational therapy visit | $20 copay |
|---|
| Occupational therapy visit | 30% coinsurance (Out-of-Network) |
|---|
| Physical therapy and speech and language therapy visit | 30% coinsurance (Out-of-Network) |
|---|
| Physical therapy and speech and language therapy visit | $20 copay |
|---|
Skilled Nursing Facility
$0 per day for days 1 through 20
$184 per day for days 21 through 100 |
|---|
| 30% per stay (Out-of-Network) |
|---|
Transportation
Vision
| Contact lenses | $0 copay (Out-of-Network) |
|---|
| Contact lenses | $0 copay |
|---|
| Eyeglass frames | Not covered |
|---|
| Eyeglass lenses | Not covered |
|---|
| Eyeglasses (frames and lenses) | $0 copay (Out-of-Network) |
|---|
| Eyeglasses (frames and lenses) | $0 copay |
|---|
| Other | Not covered |
|---|
| Routine eye exam | $0 copay |
|---|
| Routine eye exam | $0 copay (Out-of-Network) |
|---|
| Upgrades | Not covered |
|---|
Wellness Programs (e.g. fitness nursing hotline)
Reviews for Humana Honor (PPO) H5216
| 2019 Overall Rating |
|---|
| Part C Summary Rating |
|---|
| Part D Summary Rating |
|---|
| Staying Healthy: Screenings, Tests, Vaccines |
|---|
| Managing Chronic (Long Term) Conditions |
|---|
| Member Experience with Health Plan |
|---|
| Complaints and Changes in Plans Performance |
|---|
| Health Plan Customer Service |
|---|
| Drug Plan Customer Service |
|---|
| Complaints and Changes in the Drug Plan |
|---|
| Member Experience with the Drug Plan |
|---|
| Drug Safety and Accuracy of Drug Pricing |
|---|
Staying Healthy, Screening, Testing, & Vaccines
| Total Preventative Rating |
|---|
| Breast Cancer Screening |
|---|
| Colorectal Cancer Screening |
|---|
| Annual Flu Vaccine |
|---|
| Improving Physical |
|---|
| Improving Mental Health |
|---|
| Monitoring Physical Activity |
|---|
| Adult BMI Assessment |
|---|
Managing Chronic And Long Term Care for Older Adults
| Total Rating |
|---|
| SNP Care Management |
|---|
| Medication Review |
|---|
| Functional Status Assessment |
|---|
| Pain Screening |
|---|
| Osteoporosis Management |
|---|
| Diabetes Care - Eye Exam |
|---|
| Diabetes Care - Kidney Disease |
|---|
| Diabetes Care - Blood Sugar |
|---|
| Rheumatoid Arthritis |
|---|
| Reducing Risk of Falling |
|---|
| Improving Bladder Control |
|---|
| Medication Reconciliation |
|---|
| Statin Therapy |
|---|
Member Experience with Health Plan
| Total Experience Rating |
|---|
| Getting Needed Care |
|---|
| Customer Service |
|---|
| Health Care Quality |
|---|
| Rating of Health Plan |
|---|
| Care Coordination |
|---|
Member Complaints and Changes in Humana Honor (PPO) Plans Performance
| Total Rating |
|---|
| Complaints about Health Plan |
|---|
| Members Leaving the Plan |
|---|
| Health Plan Quality Improvement |
|---|
| Timely Decisions About Appeals |
|---|
Health Plan Customer Service Rating for Humana Honor (PPO)
| Total Customer Service Rating |
|---|
| Reviewing Appeals Decisions |
|---|
| Call Center, TTY, Foreign Language |
|---|
Humana Honor (PPO) Drug Plan Customer Service Ratings
| Total Rating |
|---|
| Call Center, TTY, Foreign Language |
|---|
| Appeals Auto |
|---|
| Appeals Upheld |
|---|
Ratings For Member Complaints and Changes in the Drug Plans Performance
| Total Rating |
|---|
| Complaints about the Drug Plan |
|---|
| Members Choosing to Leave the Plan |
|---|
| Drug Plan Quality Improvement |
|---|
Member Experience with the Drug Plan
| Total Rating |
|---|
| Rating of Drug Plan |
|---|
| Getting Needed Prescription Drugs |
|---|
Drug Safety and Accuracy of Drug Pricing
| Total Rating |
|---|
| MPF Price Accuracy |
|---|
| Drug Adherence for Diabetes Medications |
|---|
| Drug Adherence for Hypertension (RAS antagonists) |
|---|
| Drug Adherence for Cholesterol (Statins) |
|---|
| MTM Program Completion Rate for CMR |
|---|
| Statin with Diabetes |
|---|
Ready to Enroll?
Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST
Coverage Area for Humana Honor (PPO)
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Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.