get the Delta Dental Of Ar Fee Schedule 2013 Pdf partner that q>^{N:c0 '5xY*/KC9Nk#qw2G:_uxPb~m:$=fLW \1eaH^XBG49;k"g t=wMW$u d:eCm&GNbYkqVpI_ WebDelta Dental of Washington | PO Box 75983 | Seattle WA 98175-0983 | 877.521.2101 | DeltaDentalWA.com DD LG Premier 2015. %PDF-1.5 % Virtual Consult Group- and state-specific exceptions may apply. pBwOgeU 3)P(K^2FhLv>+SxvU}8F/i~\>cHHQ,/:0B'-ac`T2r68b)!PRJ[&}4v?S`3 How can I make my benefits go the furthest? 0000002090 00000 n You can access your electronic remittance advices (ERAs) from the Humana.com dental provider portal by accessing the Dental Providers menu and selecting View Provider Payments under the Payments menu. hbbd``b`$B@D; H0 | A$Dg` ) A?)){BYf)Q$ek:INTVTF!oE+6/$+~-,Wj44["$I"u>DN'$m! WebDelta Dental PPO plan through California State University. Premier and PPO networks, we will pay your SPEEA Scheduled Dental Plan Group # 04360. 0000012977 00000 n Qf Ml@DEHb!(`HPb0dFJ|yygs{. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. 90 0 obj <>/Filter/FlateDecode/ID[<0EF7D80C2DB26D3E1A81A2055E849515>]/Index[81 21]/Info 80 0 R/Length 61/Prev 49932/Root 82 0 R/Size 102/Type/XRef/W[1 2 1]>>stream 0000002346 00000 n endstream endobj 7894 0 obj <. Refer to the EOC booklet for coverage details and plan limitations. How can I find a participating dentist? A minimum one-year, initial contract period may be required for some dental and vision plans, excluding Dental Savings Plus. Therefore, it is always best to confirm information with yourhealth careprofessionals. Click View Our Premier network gives a smaller discount but gives you access to four out of five dentists nationwide. Delta Dental Premier Plan . You have remained in right site to start getting this info. WebThe submitted fee is the amount that the dental office charges for your service and submits to Delta Dental. |w&Vk2JIUQ kpbU}$qYs#]NflzSC%M_y WIm{SGn>95xfi'c]r_5\}GW:muM'|KC#{oG$tnRw[GU@u/l7{8;}cEl>c7% GsF WebDelta Dentals payment as payment in full, and further agree not to charge any difference between their fees and the amount paid by Delta Dental back to their Delta Dental patients. Go to our Find a Dentisttool. I receive dental insurance through my employer. 148 0 obj <> endobj N{:F&:.&U6hnp8.TFWs.Q@}&{x'cc|cVFNA 4j,2VES/fF,W5|qb41/W#lM!0l;h/s1+0 sNsPT*WeH#=P)?`?qz0v4^]=L,(*,t0gt3nl9]s 8zHd/e,\-&yV NG,/WPE8bMOXfB;L!Me_;lMz:dwM^3& ]<6tG^4oZXwc7wA)kE|CZos{,Lgw? This is just one of the solutions for you to be successful. Delta Dental has the largest network of dentists nationwide. The data is based on actual, non-discounted charges that providers have billed. Third parties with access to Humanas contracted provider network: Some Humana networks may have additional participation criteria physicians and other healthcare providers must meet to be granted participation status. billing surprises. For New Mexico residents: Insured by Humana Insurance Company. For costs and complete details of the coverage, refer to the plan document or call or write your Humana insurance agent or the company. hbbd```b`` Suppose you want to go for your regular preventive and diagnostic dental appointment. Please input information for either ZIP code or address but not both, Please enable your browser to allow this site to use your location. My Contracted Fees 1. As understood, achievement does not suggest that you have fabulous points. Specialists and general dentists recorded the fees they charged most often for over 200 dental procedures. hb```f``R |cf`ah s[3D320d+jPh;@''SZ\55|~=dp0u4X43hL `{x+l8AB6i)]@lp9 endstream endobj startxref WebKpic Delta Dental Fee Schedule 2014 below. O5g8f Dq0tt0Ht D50A8D[=X@M?CooSutoEdx /f f`rg0 yTU The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. 0000025861 00000 n ` g/ DeltaCare plans give you a broad range of coverage with no waiting period, annual maximum or Humana group life plans are offered by Humana Insurance Company or Humana Insurance Company of Kentucky. Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs. The information and content (collectively, "Content") on this website is for your general educational information only. HumanaDental digital member ID cards FAQs, PDF. How do I make sure I use a PPO dentist? How to access and interpret information provided on remittances Create an account to view your coverage, get personalized out-of-pocket cost estimates, and more! Submitting claims - All claims must be DIAGNOSTIC 0000020376 00000 n Please see your plan booklet or Policy for a complete description of plan benefits, limitations and exclusions. hTP=O0+@PuCH--Ol~z%A7FY/l.8:Cu%IsC]snN|chL}n ' You can still see out-of-network dentists, but youll pay more out of pocket. 2022 Delta Dental PPO Plan Benefit Summary Dentures and bridges (construction or repair of fixed bridges, partial, and complete dentures) Periodontics (treatment of diseases of the gums and supporting structures of the teeth) $2,000 Calendar year deductible, per member Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. The version of the Cost Estimator that is available publicly (does not require sign-in credentials) uses aggregated historical cost data for the procedure in question. Participating dentists agree to adhere to Delta Dental processing policies and are prohibited from billing a patient above the pre-negotiated fee, and agree to accept that fee as payment in full. WebDelta Dental of Colorado (Find another state) Help Center: Dentists Claims Does Delta Dental of Colorado accept electronic claims? Preventive services are included in this tool. Can you give me a comparison of my costs in network vs. out of network? 0000031542 00000 n @Ed^H?h*fd| d100Fg /TA Click the > to move your selection to the box on the right side. endstream endobj startxref Can't find your city? The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover or your out-of-pocket costs. If you are experiencing a medical or dental emergency, you should seek appropriate emergency medical or dental assistance, such as calling "911." Go365 is not an insurance product. All Rights Reserved. Delta Dental PPO Plus Premier Frequently Asked Questions. This dentist provides most of your treatment and coordinates any necessary specialist referrals. 368 0 obj <>/Filter/FlateDecode/ID[<9CBCF151ED38014EB2A0AB26D20255F5>]/Index[348 33]/Info 347 0 R/Length 96/Prev 546855/Root 349 0 R/Size 381/Type/XRef/W[1 2 1]>>stream 0000009311 00000 n In the event of a dispute, the policy as written in English is considered the controlling authority. WebConfidential Filed Fee Schedule (Updated to include CDT 2015 code terminology) Statement of Intent: I agree that each fee submitted to Delta Dental on a claim for dental services I provide to any Delta Dental patient will be these pre-filed fees or the fees actually charged and accepted as payment in full, whichever is less, consistent with the Np0(Ix8'A1F,-y|y Z8%TY9`GuZgITm06=8pC=C!Iz$KE! l$yv<8)u ^e\0n3` P WebIf you need to share the delta dental fee schedule 2022 pdf with other people, it is possible to send the file by e-mail. About; Find a Dentist; All of those matters are things that you should decide, in consultation with your dental care professionals. , PDF, Watch a video for helpful tips regarding member benefits and claims. WebDelta Dental of New Jersey P.O. You'll have a list of copayments for every covered procedure so you know all your costs for preventive, basic and major services up front. WebRecognizing the pretension ways to get this books Delta Dental Of Ar Fee Schedule 2013 Pdf is additionally useful. @C{+$aF^ADjCq)C-{ =Q[m9@q P{( (U"N Y y Oh5; d % )SPp/F w`` >E;!3J B H2H" TN+!u`),aKU@!Ds&'L@6$H d8H i#RMIvJ+rTe+E7,n)9"Aw H)4__DZW3tma,($TirN'}QZEaP_D 5@8 = t` Want to know before you set foot in the dentists office? The name of the 2023 Humana Medicare Advantage dental network in Florida is the Florida GoldPlus Dental Network. Estimates should not be construed as financial or medical advice. Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. Humana Individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc. or Humana Health Benefit Plan of Louisiana, Inc. Discount plans offered by HumanaDental Insurance Company or Humana Insurance Company. *Not sure where your company is headquartered? 0000002640 00000 n 0000007717 00000 n Your actual cost may be higher or lower than the estimate for various reasons. WebKY Medicaid Dental Fee Schedule 2022 Revised 3/17/2022 Proc Code Procedure Description UNDER AGE 21 Rate 21 and OVER Rate Notes D0145 ORAL EVALUATION FOR A PATIENT UNDER THREE (3) YEARS OF AGE AND COUNSELING WITH THE PRIMARY CAREGIVER. If you began treatment prior to your effective date of coverage, you or your prior carrier is responsible for any costs. 0000077071 00000 n claim at the PPO Rate. Webdelta dental ppo fee schedule 2022 pdf delta dental fee schedules delta dental fee schedule pdf delta dental fee schedules by zip code delta dental out-of-network fee They can use Humana tools to print a paper version of their card or email or fax a copy to your office. endstream endobj 86 0 obj <>stream WebDelta Dental has affordable individual dental plan options available for you. Like all Dentists, PPO Dentists are allowed to charge for any applicable Co-payments, Deductibles, or non-covered services. 81 0 obj <> endobj How much is it going to cost? WebSCHEDULE A Description of Benefits and Copayments The benefits shown below are performed as deemed appropriate by the attending Contract Dentist subject to the Search for in-network dentists in your area using your current location or ZIP code with ourFind a Dentisttool. Find a dentist near you. 7913 0 obj <>stream Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. You have remained in right site to start getting this info. Webunder copyright by the American Dental Association. Connect with your Delta Dental company to learn more. 7906 0 obj <>/Filter/FlateDecode/ID[<6A22589A1FC506448F51EC6CE5CCD5A3><7FE5D63132C3D543B8A2DB0D0F689003>]/Index[7893 21]/Info 7892 0 R/Length 82/Prev 914206/Root 7894 0 R/Size 7914/Type/XRef/W[1 3 1]>>stream This website shows estimates of certain dental care costs. WebDelta Dental of Washington | PO Box 75983 | Seattle WA 98175-0983 | 877.521.2101 | DeltaDentalWA.com DD LG Premier 2015. Payment is based on the SPEEA fee schedule with Delta Dental. This exclusive survey provides you with an analysis of self-reported fees by procedure from a nationwide, random sample of dentists. Use our Find a Dentisttool to search for PPO dentists identified by the Greater Savings icon." delta dental plan kaiser permanente web more than 25 000 aliated dental providers in california no deductible for preventive services up to 1 000 of services per year your dental plan is underwritten by kaiser permanente insurance company WebDelta Dental Of Ohio Fee Schedule Cxeb Ksiilxm Yeah, reviewing a ebook Delta Dental Of Ohio Fee Schedule Cxeb Ksiilxm could go to your close associates listings. How do I submit claims to Delta Dental? Rates are subject to periodic change without prior notification. 4993 37 No more claims to file or 4 Applies only to procedures covered under your plan. Delta Dental. Medical Assistance Program Dental Fee Schedule May 2, 2022. You will then see Remittance Inquiry (Humana) under Additional Remittance Tools. Refer to your benefit plan to determine whether these requirements apply to you. WebSchedule A - Description of Benefits and Copayments.. 13 Schedule B - Limitations and Exclusions of Benefits.. 37 . Health information changes quickly. 0 0000001055 00000 n hU[k0+zl. If a contracted dental provider no longer wants to have third parties accessing its services under the contract the dental provider and Humana entered into, the contracted dental provider can reach out to its Humana dental representative to be removed from third-party access. Yes. You also may contact Delta Dental PPO customer service at (800) 626-3108. U%}TLfRSt|I'_p:Z9T@p\}$1*4f~y In states, and for products where applicable, the premium may include a $1 administrative fee. Webdental entitys Type 2 NPI (if different) to npi@delta.org Please also include the dentists name, practice name, address and license number. Check out our DCUSA network video. Updated March 2022Humana enters into agreements that grant some third parties access to Humanas contracted provider network. Individual applications are subject to eligibility requirements. Youll save the most when you see PPO dentists. 0 Please scroll down and accept to proceed. (those who choose not to participate in PPO or Premier) dont offer negotiated discounts. Delta Dental Premier Plan . Webdental entitys Type 2 NPI (if different) to npi@delta.org Please also include the dentists name, practice name, address and license number. Humana legal entities that offer, underwrite, administer or insure insurance products and services. DeltaCare USA, Get paid faster and reduce administrative paperwork with electronic funds transfer (EFT) and electronic remittance advice (ERA). {[ For example, if the dentists usual fee for a filling is $200 and the discount dental plan has provided a 40% discount, then you will end up paying $120 to the dentist directly. WebClaim/Claim Form Information.the.dentist.submits.to.the.dental.plan. 0000008809 00000 n P.O. endstream endobj 149 0 obj <> endobj 150 0 obj <> endobj 151 0 obj <>stream Pre-authorizations or referrals are required for certain benefit plans and certain dental care providers. 0000010743 00000 n 0000005788 00000 n The Delta Dental announcement addresses a shift to regional standard Premier fee schedules (thereby eliminating Premier fee fillings), creating an aggregate increase for PPO general dentist fees, and reducing Premier reimbursement for most oral surgeons, endodontists and periodontists. 0000016709 00000 n Can you give me a comparison of my costs in network vs. out of network. Search. WebThe Humana Dental Medicare network provides benefits to Humana members enrolled in Medicare Advantage and prescription drug plan programs. With your DeltaCare USA plan, when you visit a network dentist, you'll: Save on out-of-pocket costs. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Check out Virtual Consult, Check out our new DeltaVision plans ^o /B )L^6 g,qm"[Z[Z~Q7%" The American Dental Association may periodically change CDT codes or definitions. tqX)I)B>== 9. Can I go to any dentist I want with this plan? %%EOF 0 Zq [r Administered by Humana Insurance Company. 0000040598 00000 n WebLearn how to identify members and verify their dental coverage, easily submit claims and receive payment for services and supplies. hwTTwz0z.0. You have remained in right site to start getting this info. V*T/` C1H? b@AT 1z* I2~ WebDelta Dental of California 560 Mission Street, Suite 1300 San Francisco, CA 94105 888-282-8528 deltadentalins.com Administered by: Delta Dental Insurance Company P.O. fM. WebDelta Dental Premier is one of our five contracted national network-based programs. Refer to your benefit plan to determine whether preventive services are covered for you. Enter the Humana Dental Payer Space and access the ERA/EFT Enrollment application. ,9g4crDe`py:0ocnjvl)tDh}.~K m=_ Accept Delta Dental of Oregon benefit payments for services provided. FAQs About Participation with Delta Dental Patient Direct. Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Box 14611 The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan. In Maryland, Delta Dental PPO. Submit a list of fees to be filed with Delta Dental of Know your costs for covered procedures up front. Claims will be processed when received according to your plan provisions. Can I go to any dentist I want with this plan? For more information, refer to these frequently asked questions and answers. To begin using the Dental Care Cost Estimator tool, click the Agree button below. WebThe OCC Dental Insurance Program consists of two dental options: a preferred provider organization (PPO) and a dental health maintenance organization (DHMO). 0000077030 00000 n SCHEDULE B LIMITATIONS AND EXCLUSIONS OF BENEFITS For a low annual membership fee, individuals and families can receive discounted fees when they go to a participating dentist. %PDF-1.6 % Mail it to Delta Dental at the address shown below.. Any Subscription Charges If there is any conflict or discrepancy between the Content on this website and your coverage documents, your coverage documents will control. J kujbplc#vv9~KNpxDKXnNd !KdHM2^)}zo"ktD;Y5s6tVH't_h4k,Y@'F6'+t+U;W*D2VFut8E=s!_$bPqvi,f?7HWJ6[QmlgOuAa4j="*-uQqj0mw$)yIZzT]Y$x=zUJJ'zS/DfKN1AWiY~`$sNl]M,t2;zZ4ju ~\)1/\+ER;s? Both dental plans provide the same services. 0000081041 00000 n 0000008367 00000 n Some plans may also charge a one-time, non-refundable enrollment fee. %PDF-1.6 % WebPlease note: This fee schedule applies to procedures performed by a General Dentists only. WebDelta Dental Patient Direct is a discount card program based on the Delta Dental PPO fee schedule. Contact your company's human resources department. With Delta Dental as the programs administrator, these two options are known as the Delta Dental PPOTM plan and the DeltaCare USA (DHMO) plan. hUOSWX`}'D_a^1SNp+R"`HP\(J6C[D6\j0sALw__{y H ?WT)h`E!D^d>|fm*aRO3S'_TM-,^Y3TH]9n":iofVG+Ue2Pb 99Nfb=W>N?=QG%Pex??? To promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service, and value. WebKpic Delta Dental Fee Schedule 2014 below. WebDelta Dental Of Ohio Fee Schedule Cxeb Ksiilxm Yeah, reviewing a ebook Delta Dental Of Ohio Fee Schedule Cxeb Ksiilxm could go to your close associates listings. endstream endobj 87 0 obj <>stream If you elect to participate in this plan, you'll have a two-tiered fee schedule: Delta Dental Premier and a slightly reduced fee schedule for Delta Dental PPO. PPO fees are posted to the National Provider File and accepted nationally by other Delta Plans. Estimates may vary depending on your benefit plan and the state you live in. 0000033685 00000 n $32.50 n/c D0150 COMPREHENSIVE ORAL EVALUATION Be sure to select the Delta Dental PPO Plus Premier network. Out-of-network dentists $E}kyhyRm333: }=#ve hb```b``se`e` @16L@P iS;~1fm,Jxo0~e d {@ O ka$31b0;p7AyFCt+?:ro@MoCOW{\\uKs[Y. DeltaCare USA plans are underwritten in these states by these entities: CA Delta Dental of California; DC(Policy I-P-DC-dc-20) and FL Delta Dental Insurance Company; MD and TX Alpha Dental Programs, Inc.; UT Alpha Dental of Utah, Inc.; NY Delta Dental of New York, Inc.; NV Alpha Dental of Nevada, Inc.; PA Delta Dental of Pennsylvania. 0000000016 00000 n Network Overview Take a tour of the Connection For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. 2020 Survey of Dental Fees, Download Supporting Materials (Free for ADA members) ,B_tx,?_BU-AdM#B?Y|k:7faNH >dW gj iApwTu}hoh? You can change your DeltaCare USA dentist at any time. 0000014888 00000 n WebRecognizing the pretension ways to get this books Delta Dental Of Ar Fee Schedule 2013 Pdf is additionally useful. P.O. Get preventive care (like cleanings and exams) at low or no cost. Participating dentists agree to adhere to Delta Dental processing policies and are prohibited from billing a patient above the pre-negotiated fee, and agree to accept that fee as payment in full. Download Supporting Materials(Free for ADA members) As understood, achievement does not suggest that you have fabulous points. 0000037948 00000 n the SingularDental fee schedule for pricing details. WebDELTA DENTAL PATIENT DIRECT MEMBER FEE SCHEDULE MEMBER PAYS DENTAL SERVICE (Maximum Charge) Delta Dental of Illinois DDIL.PD.FS.0802 hWF+HYr :1U`vh$~#_EJC $!yo70EN3"&IHC" !#_BD,'>nN"~.O_EHiL Download Supporting Materials (Free for ADA members) 2022 Survey of Dental Fees. Payment is based on the SPEEA fee schedule with Delta Dental. Mandatory Medicare compliance requirements, PDF. Previous Next. 7893 0 obj <> endobj The accepted fee is the amount your dentist agrees to accept from Delta Dental as full payment for your dental service. The plans may have different dentists. WebDelta Dental of Minnesota 1 -877 631 8954 . 155 0 obj <>/Filter/FlateDecode/ID[<11D0ED0D772846A5BDACC2E76C6D3585>]/Index[148 13]/Info 147 0 R/Length 54/Prev 390647/Root 149 0 R/Size 161/Type/XRef/W[1 2 1]>>stream WebDelta Dental of Minnesota Experience the Delta Dental Difference No waiting periodsyou have full benefits the day your coverage begins. WebDelta Dental PPO Plus Premier Plan at a Glance | Delta Dental of New Jersey Online tools Dental plans Dental health Home > Tools & resources > Plan information > PPO Plus Premier At a Glance Delta Dental PPO Plus Premier Plan at a Glance Delta Dental PPO Plus Premier gives you access to approximately 154,000 participating dentists. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. $l- Km<2m9M~m|_Ll03aul{- Ytg4^ydt[)>?DrP9d>g) \3+ECqDbBq"YS[07Dq{r4M^j3"( NPW* *uIAqn+1c/0PrP!Q|fCMTDY~Wb~ljw,]"W|U]w*;G:u( {^0SDU2[9OBvHg:M`'|B7UPy]UKkIQv.$SJ;EHHL'SiQLm)g)8#umFTDv|NK\=d6{eKHZ1ev,?&Fna~*+, (Changes requested between the first and 15th of the month are effective immediately; changes received on or after the 16th of the month will be effective on the first of the next month.). The Humana Member Summary is a tool that displays patient-specific, clinically relevant information in a standardized format to help you identify opportunities to improve clinical outcomes and reduce medically related costs. The national network of Delta Dental companies protects more smiles than any other insurance company. WebProtect your smile and wallet with a DeltaCare USA plan from Delta Dental. %%EOF Get started here. The Humana Dental Medicare network provides benefits to Humana members enrolled in Medicare Advantage and prescription drug plan programs. This communication provides a general description of certain identified insurance or non-insurance benefits provided under one or more of our health benefit plans. Dental Network Names in and outside of Florida. Web2019 ADA Dental Claim Form Click Here . Benefits described in this comparison are guaranteed only when you select a participating dentist from Deltas networks. Under a dental discount plan, you pay the dentist directly at the time of service on a pre-negotiated rate. Delta Dental of California and Affiliates is a part of Delta Dental Plans Association. 0000008456 00000 n lowest cost network in which your dentist Plan participants may not always inform a dental office of their participation in the MetLife PDP program. Find health-related articles, product discounts and wellness benefits, Connect remotely with your patients using WebWhen a service is denied and the reason for denial is considered integral to another dental service, the participating dentist agrees to the negotiated fee as adjudicated and cannot charge the participant for the denied integral service. 160 0 obj <>stream Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania and affiliates. If you are eligible to use our online application, please review this important information. They also may present a digital ID card using their MyHumana mobile app. The description of different treatment categories, and the inclusion of particular services in a treatmentcategory,is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. ]xl8/K"Xg%`tp2e JjkK/?0vH>^GHc`Y6{E9cioJX8 qZiu_'-z``MYG%=$Te+X^pGZbu6I In the event of any disagreement between this communication and the plan document, the plan document will control. Cost estimates for services provided by out-of-network dentists (available in the out-of-network estimator) are based upon submitted claims data for out-of-network providers. Medical Assistance Program Dental Fee Schedule: provider : 20 : 20 ; ADJUNCTIVE GENERAL SERVICES . Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc. New Mexico: Humana group dental and vision plans are insured by Humana Insurance Company.