Does Humana cover dental implants

Yes! As of 2023 Humana dental insurance provider cover dental implants. We are a Humana preferred provider office that offers anxiety-free sedation services including twilight sedation and general anesthesia. You as the patient may be entitle to receive sedation benefits available under the Humana dental policy.

We make every effort to keep down the cost of your dental care by accepting Humana PPO. We are in-network with many Humana plans serving the city of Plantation and Fort Lauderdale, FL. Below is a list of some of the major dental Humana insurance plans honored by our practice. We participate in most major dental insurance programs; we accept all insurance as either full or partial payment toward treatment, as long as we take the specific Humana insurance plan.

We call Humana dental insurance on your behalf and explain all the insurance fees before treatment begins. Please remember services are subject to change; additional services may be required and patient fees may be subject to change at that time. Any additional treatment found to be required must be paid for as treatment is carried out.

How Does Humana cover dental implants?

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As of 2023 plans for the surgical implant, coverage is available.

Prior authorization may be required for certain specialty care treatments like dental implants. Only those procedures that are medically necessary and listed on the plan’s Patient Fee Schedule are covered.

Services related to the surgical placement of a dental implant may be limited to one per year with replacement of a surgical implant frequency limitation of one every 5-10 years.

The tooth prosthesis over implant replacement is limited to every 5 years it cannot be repaired. The frequency limitations of certain other covered services are set forth in the Patient Fee Schedule manual which we have it updated at our Plantation and Fort Lauderdale

Humana dental implant insurance claims

We provide you with the best possible care. Anytime you have a question about your dental Humana dental insurance, feel free to ask us. We recognize that dental insurance is becoming more complex and difficult to understand every day. We are happy to assist you in processing the dental implant insurance claim so that you receive your optimal allowable benefits.

In order to achieve these goals, we need your assistance and your understanding of our payment policy. We ask you to pay for each visit unless other arrangements have been made prior to your appointment. When extensive dental care is necessary or when dental insurance is involved, financial arrangements can be made with our Office Manager Nichol.

Humana dental insurance service

Please keep in mind the following: Humana dental insurance

  1. Your insurance coverage is a contract between you, your employer, and the insurance company; we are not a third party to that contract.
  2. Our fees are considered to fall within the acceptable range by most insurance companies. Nevertheless, some insurance companies choose to set up their arbitrary schedule of fees, which bears no relationship to current standards and cost of care in this area.
  3. Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will “downgrade” or not cover. Almost all “Cosmetic Procedures”(front teeth porcelain veneers, teeth whitening, some tooth-colored fillings and various gum shaping surgery) are not covered by insurance and full payment is required the day of treatment unless prior arrangements have been made.
  4. Dental Implants often covered by Humana dental insurance, so we ask our patients to take care of the fee the day of treatment. We can bill dental insurance for the prosthetic portion (the crown) of the implant procedure, but payment in this area is not predictable. We are not able to process dental implant procedures under your medical insurance since we are a dental office.

We would like to emphasize that as a dental care provider, our relationship is with you, the patient, not your insurance company. While the filing of claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered.

How much does Humana cover for implants?  

Humana dental implants plans vary in cost and coverage depending on where you live, but you can apply for a free quote online by heading to the Humana website and entering your zip code in the site’s Cost Estimator tool. There are three types of plans for individuals that you can purchase to cover implants:

  • Humana PPO Plan offers about 50% coverage for implants
  • Many Humana Plan offers about 40% coverage for implants
  • Humana PPO Plus Premier Plan offers 40% coverage for implants (or 30% coverage for out-of-network)

For a further example of pricing, we can look at the Humana PPO Plan. This plan covers 100% of routine and preventive diagnostic procedures, about 80% of basic procedures like fillings, root canals, and extractions, and 50% of major procedures like bridges and implants. Note that waiting periods, annual maximums, and deductibles apply, and these can drastically reduce the amount of coverage you can use toward implants.

How does going to Humana Dentist work in Florida?

as of 2023, Humana and other dental insurance work in much the same way that medical insurance works. For a specific monthly rate called “premium”, you are entitled to certain dental benefits, usually including regular dental checkups, cleanings, and certain copayment services like wisdom teeth extraction, root canal, and periodontal gums treatment. Some Humana plans will provide broader coverage than others and some will require a greater financial contribution on your part when services are rendered. Some Humana plans may also provide coverage for certain types of dental implants and laser periodontal surgery like LANAP and Periodontal gum REPAIR like Deep Pocket Therapy.

Humana Dental Insurance Plans overview

Typically, Florida dental PPOs plans like Humana offers a broader selection of dentists providers than HMO managed-care plans. With a Humana PPO, the patient pays for covered services after it receives a bill, which means that you may have to pay up front and then obtain reimbursement from your Humana insurance carrier later.

Humana Dental PPO

A Humana PPO insurance plan applies the principles of PPO insurance to a dental network. You are free to choose any dentist you like from either the in-network or out-of-network lists, and you receive an agreed-upon level of benefits from the insurer according to the list you use. These types of policies are popular among both employer-provided and individual dental insurance plans because they offer the customer flexibility and freedom.

You may go to any dentist, however, for maximum Humana benefits at the lowest cost visit a participating network dentist.

What’s the benefit of seeing an in-network Humana dentist?

If your dentist is not on the network with Humana you still receive benefits, but you will pay higher out-of-pocket costs for the dental services.

What is the billing process with Humana?

  • Prior to receiving services, review your Humana plan certificate for important plan information, such as deductibles, copayments or required waiting periods.
  • When you visit a Humana dentist, simply present your Humana identification card. The dentist will submit the claim to Humana insurance on your behalf.
  • Humana will review the claim and reimburse the dentist for eligible charges.
  • Humana will mail an Explanation of Benefits (EOB) to your home. Your Humana dentist will bill you for your portion of the charges. If you visit a participating Humana PPO network dentist, your dentist cannot bill you for amounts over the negotiated fees, ensuring lower out-of-pocket costs for you. You pay your Humana dentist directly, if applicable.

What services are covered by Humana?

Preventive services

  • Oral examinations
  • Dental X-rays
  • Dental Cleanings
  • Topical fluoride

Basic services

  • Gum treatment
  • Root canals
  • Scaling and root planing – deep cleaning
  • Emergency dental care
  • Basic extractions of erupted tooth or root
  • Fillings Routine extractions

Major services

  • Porcelain Crowns (caps)
  • Dental Implants
  • Bridgework
  • Dentures
  • Periodontal gum laser surgery
  • Wisdom teeth extractions
  • Dental Implants
  • Sedation dentistry

Humana PPO benefit summary FAQs

What kind of plan do I have and what are my benefits? You need to sign in to your member account to find out what plan you have and the dental services it covers. We can verify benefits on your behalf.

How do I check to see if I have met my deductible and/or what is remaining on my annual maximum? You would need to sign in to your Humana member account to access information about your plan. We can verify this information on your behalf.

Do I need to select a primary care dentist? If you have coverage through Humana dental care, our dental health maintenance organization (DHMO) plan, you will need to choose a primary care dentist (general dentist) from our Humana network.

What are the benefits of visiting a Humana network dentist?

When you visit a network dentist, you’ll enjoy the following benefits:

  • Lower out-of-pocket costs than if you received care from an out-of-network dentist because our network dentists have agreed to accept reduced fees.
  • Balance billing is not allowed. Our network dentists agree to accept Humana’s fee and the patient co-payment or deductible (if applicable) as full payment.
  • There are no forms for you to fill out because our network dentists submit claims directly to Humana.
  • We pay the dentist directly, so you don’t have to wait for a reimbursement check.
  • ou can have confidence in our ongoing relationships with our network dentists, who we’ve ensured meet national credentialing standards.

Does Humana require claim forms? Where should claims be sent? We will submit claim forms on your behalf. If you do need to submit a claim yourself, we have forms available for download.

Humana Insurance Eligibility – How do you receive your eligibility information?

Humana insurance company receives your secure eligibility information from your employer. It is sent in through paper enrollment forms or by an electronic file. Your employer determines your Humana coverage effective date or termination date of coverage based on their benefit eligibility guidelines.

Humana Insurance ID cards – How and when will I receive my ID card for my Humana PPO plan?

You should receive a Humanl ID card approximately 7-10 days after you have enrolled.

How do I find a Humana dentist?

You may find a network Humana dentist on your insurance company’s online directory. You may search for a dentist by name, specialty, zip code like 33324, or miles you are willing to travel. You can search by city and state like Plantation FL, or county and state like Broward Fl. You’ll even find maps and directions to your dentist’s office. For your convenience, our dental office is located in Plantation, FL 33324.

If you have no computer, after you enroll, you can call your Humana PPO dental customer service toll-free for answers. You can call our experienced dental staff they are ready to help!

Humana claim reimbursement – How will my Humana claims be reimbursed?

When you visit a Humana PPO participating dentist: Participating dentists have agreed to offer certain services at a negotiated rate — so you generally pay less out of pocket for your care.

  • Show your Humana ID card during your visit.
  • If your insurance plan has a deductible (a dollar amount you must pay for covered expenses in a plan year), you must meet the deductible before your insurance plan covers your eligible dental expenses.
  • After you meet your deductible, you will pay a coinsurance amount (a percentage of covered expenses) at the time of service. Read your Humana Benefits Summary to learn this amount.
  • Your Humana dentist may submit your claims for you.

If you visit a nonparticipating Humana dentist:

Nonparticipating Humana dentists may bill you their normal fee for procedures. Your plan provides benefits for covered expenses at the established charge Humana determines to be usual and prevailing for the service in that geographical area. When we determine the amount of a charge that is covered we may consider other factors, including the established charge in other areas. Humana determination of the established charge does not suggest your dentist’s fee is not reasonable and proper. Your dentist may bill you for the difference between their normal fee and Humana usual and prevailing fee.

  • Your plan may have a deductible. The deductible is the dollar amount you must pay before your plan covers your eligible dental expenses.
  • You may pay a coinsurance percentage or flat dollar amount. That means you’ll pay a percentage of covered expenses at the time of service. See your plan documents for specific amounts.
  • You or your dentist can submit a claim form for reimbursement.

Please note if you are enrolled in a PPO Max plan, your out-of-network benefits will be based on the in-network negotiated rate in the applicable geographic area. Please see your plan document or contact customer service for details on your specific plan.

BOOK your dental appointment ONLINE!

Humana dental implants

In the development of Humana dental implant series humana acknowledge the value of simplicity. The system offers a wide range of products, including implants and prosthetic parts, designed in one platform that fits all implant diameters.

Advantages of humana dental implants

The unique and simple system makes the dentist’s work convenient and accomplishes several major advantages:

Wide range of products with proven clinical biocompatibility
Fast and easy insertion
High primary stability
High predictability
High success rates, in immediate loading

Unique Humana dental implants features

Humana dental Implants unique features include:
Great control during placement
Greater initial placement stability
Self drilling feature
Self tapping feature
Self condensing feature


Dental Insurance Provider Dentist Reviews

Dental insurance provider patient reviews on dental implants. “I am elated with my new all-on-4 implants.
The staff and Dr. Arocha are fabulous people and made my experience of getting plants very relaxing and pleasurable.
Very professional and conscientious staff. If you are considering where to go for all-on-4 implants, I highly recommend Dr.Arocha.
” Max Arocha DMD actual patient review. Dental insurance provider dentist review

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Humana dental online booking

Our online booking system for dental appointments works by processing secure online reservations made through our website. The data is then passed to a front disk dental receptionists which manage our dental appointments.

Book Humana dental appointment ONLINE!

You can manage your Humana dental insurance plans access dental health resources. For you as a patient, PPO Dental provides the freedom to visit any licensed dentist or save more by visiting one of over ten of thousands Humana Preferred Dentist Program dentist locations nationwide.