Humana Dental Smart Choice - Low - 66105AZ0620002 Health Insurance Plan
Humana Insurance Company health insurance plan with the Plan ID 66105AZ0620002. The plan is called Humana Dental Smart Choice - Low.
| Health Insurance Plan ID | 66105AZ0620002 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2025 | ||||||||||||||||||
| State | Arizona | ||||||||||||||||||
| Health Insurance Issuer | Humana Insurance Company | ||||||||||||||||||
| Plan Marketing Materials URL | Marketing URL | ||||||||||||||||||
| Health Insurance Plan Variant | 66105AZ0620002-01 | ||||||||||||||||||
| Provider Network(s) | PREFERRED | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 16 Sep 2025 15:17 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Thu, 08 Aug 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 16 Sep 2025 15:17 GMT |
Benefits of Humana Dental Smart Choice - Low Health Insurance Plan, 66105AZ0620002-01
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Accidental Dental
Exclusions: nan See plan brochure for plan details and limitations and exclusions |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Basic Dental Care - Adult
Exclusions: nan 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
Exclusions: nan See plan brochure for plan details and limitations and exclusions |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Dental Check-Up for Children
Limit: 1.0 Visit(s) per 6 Months Exclusions: nan nan |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Dental X-rays
Limit: 1.0 Procedure(s) per 6 Months Exclusions: nan Panoramic and Complete Series X-Rays have a frequency of 1 per 5 years |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Denture Adjustments
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Denture Reline and Rebase
Limit: 1.0 Procedure(s) per 3 Years Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Extractions
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Fillings
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Immediate Dentures
Exclusions: nan Benefit is 1 per 5 years |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Implants
Exclusions: nan Benefit is 1 per 5 years |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Initial Placement of Bridges and Dentures
Exclusions: nan Benefit is 1 per 5 years |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Major Dental Care - Adult
Exclusions: nan See plan brochure for plan details and limitations and exclusions |
YES | 100.00% |
100.00% |
| Major Dental Care - Child
Exclusions: nan See plan brochure for plan details and limitations and exclusions |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Minor Restorative Services
Exclusions: nan Benefit is 1 per 5 years |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Occlusal Adjustments
Limit: 1.0 Procedure(s) per 3 Years Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Oral Surgery
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Orthodontia - Adult
Exclusions: nan nan |
NO | ||
| Orthodontia - Child
Exclusions: nan Medically necessary orthodontia for child. |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Partial Pulpotomy
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Periodontal and Osseous Surgery
Limit: 1.0 Procedure(s) per 3 Years Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Periodontal Maintenance
Limit: 4.0 Procedure(s) per Year Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Periodontal Root Scaling and Planing
Limit: 1.0 Procedure(s) per 2 Years Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Periradicular Surgical Procedures
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Post and Core Build-up
Exclusions: nan Benefit is 1 per 5 years |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Recementation of Space Maintainers
Exclusions: nan nan |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Removal of Fixed Space Maintainers
Exclusions: nan nan |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Root Canal Therapy and Retreatment
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Routine Dental Services (Adult)
Limit: 1.0 Visit(s) per 6 Months Exclusions: nan nan |
YES | No Charge |
30.00% Coinsurance after deductible |
| Sealants
Limit: 1.0 Procedure(s) per 3 Years Exclusions: nan nan |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Tissue Conditioning
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
| Topical Fluoride
Limit: 2.0 Visit(s) per Year Exclusions: nan nan |
YES | No Charge after deductible |
50.00% Coinsurance after deductible |
| Vital Pulpotomy
Exclusions: nan nan |
YES | 50.00% Coinsurance after deductible |
50.00% Coinsurance after deductible |
Humana Dental Smart Choice - Low Health Insurance Plan Variant 66105AZ0620002-01 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 | 2025 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Low On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 0.995208455094121 |
| First Tier Utilization | 100% |
| HIOS Product ID | 66105AZ062 |
| Import Date | 2024-08-08 01:02:06 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Guaranteed Rate |
| New/Existing Plan | Existing |
| Issuer ID | 66105 |
| 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 | $50 |
| 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 | $50 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $850 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $425 per person |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $425 |
| 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 | AZN001 |
| Out of Country Coverage | No |
| 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 | 2025-01-01 |
| Plan ID (Standard Component ID with Variant) | 66105AZ0620002-01 |
| Plan Marketing Name | Humana Dental Smart Choice - Low |
| Plan Type | PPO |
| Plan Variant Marketing Name | Humana Dental Smart Choice - Low |
| QHP/Non QHP | Both |
| Service Area ID | AZS001 |
| Source Name | HIOS |
| Plan ID | 66105AZ0620002 |
| State Code | AZ |
| URL for Enrollment Payment | URL |
Copay & Coinsurance of Humana Dental Smart Choice - Low Health Insurance Plan, 66105AZ0620002
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Humana Dental Smart Choice - Low, 66105AZ0620002 Health Insurance Plan, 66105AZ0620002
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Does Humana Dental Smart Choice - Low Health Insurance Plan, 66105AZ0620002 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (66105AZ0620002) Health Insurance Plan, Variant (66105AZ0620002-01) have Out Of Country Coverage?
Does (66105AZ0620002) Health Insurance Plan, Variant (66105AZ0620002-01) have Out of Service Area Coverage?
Disclaimer: This is based on the import(Date: Tue, 16 Sep 2025 15:17 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