Humana – Dental Benefits That Don’t End at the Annual Maximum
Humana – Dental Benefits That Don’t End at the Annual MaximumJanuary 29, 2019
Example of Humana’s Extended Annual Maximum Benefit:
Kevin goes to the dentist regularly, but rather unexpectedly his dentist tells him there’s an issue. He’ll need a root canal and a crown. These are likely to cost more than his annual maximum benefit. Kevin has a 100/80/50 Traditional Preferred Plan (including periodontics and endodontics) with a $50 deductible and has met his $1,000 annual maximum. Typical rollover plans give members incentive to wait until a new plan year to take action on those costly but necessary dental procedures. Fortunately, Kevin finds that Humana’s Extended Annual Maximum plans are different.
With Extended Annual Maximum, Kevin has the benefits he needs when he needs them. That immediate attention to dental care may benefit Kevin’s employer in the future by lessening claim costs from recurring or worsening oral issues. Now that he needs a root canal and a crown, his Extended Annual Maximum plan will cover more.
In the example, the plan has already reached its annual max of $1,000 and Kevin has paid his $50 deductible. Kevin submits a claim for $875 for the root canal, and Extended Annual Maximum picks up 30 percent of the cost, or $262.50. When Kevin later needs a crown, Extended Annual Maximum also pays 30 percent of that cost, $240. Kevin saved $502.50 in out of pocket costs with a Humana plan.
Available on PPO and Traditional Preferred Plans
As a part of Humana PPO and Traditional Preferred plans, Extended Annual Maximum takes over after a plan’s annual maximum benefit is reached. It gives employees 30 percent coinsurance on preventive, basic and major services, and it makes those unexpected and costly dental procedures – such as root canals and crowns – easier to afford.
- Extended Annual Maximum doesn’t force covered employees to use only in-network providers in order to get the benefit. If they find that the services they need are best performed by an out-of-network provider, their coinsurance still applies.
- There is no cap on dollars that may be paid, which means they can take advantage of the benefit whenever it’s needed within the plan year.
- Ensures employees get the most out of their benefits.
- No need to seek and track carry-over dollars for employees.
- Affordable and easy to use.
- Employees and dependents have the same benefits.
- No confusing claims paid thresholds to meet.
- No provider restrictions.
To learn more, download the flyer.
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