Humana Dental Smart Choice Basic - 46958UT0470002 Health Insurance Plan

Humana Insurance Company health insurance plan with the Plan ID 46958UT0470002. The plan is called Humana Dental Smart Choice Basic.

Health Insurance Plan ID 46958UT0470002
Health Insurance Plan Year 2023
State Utah
Health Insurance Issuer Humana Insurance Company
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 46958UT0470002-00
Provider Network(s) ['UTN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 16 Apr 2024 06:19 GMT).

Providers Utah All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard Off Exchange Plan - 46958UT0470002-00

Standard On Exchange Plan - 46958UT0470002-01

Last Plan Update Date Wed, 17 Aug 2022 00:00 GMT
Last Import Date Tue, 16 Apr 2024 06:19 GMT

Benefits of Humana Dental Smart Choice Basic Health Insurance Plan, 46958UT0470002-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult

See plan brochure for plan details and limitations and exclusions

YES

40.00% Coinsurance after deductible

40.00% Coinsurance after deductible
Basic Dental Care - Child
NO
Dental Check-Up for Children

Limit: 2.0 Procedure(s) per Benefit Period

Routine cleaning, exams, x-rays and fluoride. Sealants once every five years.

YES

No Charge after deductible

30.00% Coinsurance after deductible
Major Dental Care - Adult
NO
Major Dental Care - Child
NO
Orthodontia - Adult
NO
Orthodontia - Child
NO
Routine Dental Services (Adult)

Limit: 2.0 Visit(s) per Benefit Period

See plan brochure for plan details and limitations and exclusions

YES

No Charge

30.00% Coinsurance after deductible

Humana Dental Smart Choice Basic Health Insurance Plan Variant 46958UT0470002-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1
First Tier Utilization 100%
HIOS Product ID 46958UT047
Import Date 8/17/2022 20:01
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 46958
Issuer Marketplace Marketing Name Humana
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Not Applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual $45
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Out of Network, Individual $45
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $375
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
Metal Level Low
Multiple In Network Tiers No
National Network Yes
Network ID UTN001
Out of Country Coverage Yes
Out of Country Coverage Description Out of Country Coverage is covered for any expense incurred for services received outside of the United States as required by law for emergency care services.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Any covered expense incurred for services received from an out of network provider will be covered at a lower coinsurance, based on the maximum allowable fee and providers can balance bill which will result in higher out of pocket costs, except for covered expense incurred for services received outside of the service area as required by law for emergency care services.
Plan Brochure URL
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 46958UT0470002-00
Plan Marketing Name Humana Dental Smart Choice Basic
Plan Type PPO
Plan Variant Marketing Name Humana Dental Smart Choice Basic
QHP/Non QHP Both
Service Area ID UTS001
Source Name SERFF
Plan ID 46958UT0470002
State Code UT
URL for Enrollment Payment URL

Copay & Coinsurance of Humana Dental Smart Choice Basic Health Insurance Plan, 46958UT0470002

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Humana Dental Smart Choice Basic, 46958UT0470002 Health Insurance Plan, 46958UT0470002

  • Does Humana Dental Smart Choice Basic Health Insurance Plan, 46958UT0470002 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (46958UT0470002) Health Insurance Plan, Variant (46958UT0470002-00) have Out Of Country Coverage?

    Yes. Details: Out of Country Coverage is covered for any expense incurred for services received outside of the United States as required by law for emergency care services.

    Does (46958UT0470002) Health Insurance Plan, Variant (46958UT0470002-00) have Out of Service Area Coverage?

    Yes. Details: Any covered expense incurred for services received from an out of network provider will be covered at a lower coinsurance, based on the maximum allowable fee and providers can balance bill which will result in higher out of pocket costs, except for covered expense incurred for services received outside of the service area as required by law for emergency care services.

 

Disclaimer: This is based on the import(Date: Tue, 16 Apr 2024 06:19 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API