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Humana Health and Wellness
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Dental insurance plans questions, and answers

Frequently Asked Questions

We've put the answers to the many common questions close at hand. If this section of our site doesn't answer your question, click 'contact us' to find out how to reach us by phone or e-mail.

How does the plan differ from other dental plans?

The Federal Advantage Plan emphasizes prevention and cost control. Important features of the plan are:

  • No waiting period for orthodontic or any other services.
  • No deductibles and $0 co-payment for preventive care.
  • $15,000 annual maximum-the highest among federal dental providers.
  • You can see any network dentist or specialist at any time. There are no referrals.
Who is Humana?

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation’s largest publicly traded health and supplemental benefits companies. Humana is a full-service benefits solutions company, offering a wide array of health and supplemental benefit plans for employer groups, government programs and individuals. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience.

How do I enroll in the plan?

You must use BENEFEDS to enroll or change enrollment in the Federal Advantage Plan. BENEFEDS is a secure enrollment Website (www.BENEFEDS.com) sponsored by OPM. To enroll simply enter your name, personal information such as your address and Social Security number, the agency you work for (or retirement system that pays your annuity), and select the Federal Advantage Plan. If you do not have access to a computer, call 1-877-888-FEDS (1-877-888-3337), TTY number 1-877-889-5680, to enroll or change your enrollment.

Note: You cannot enroll in a FEDVIP plan using the Health Benefits Election Form (SF 2809) or through an agency self-service system, such as Employee Express, PostalEase, EBIS, MyPay, or Employee Personal Page. However, those sites may provide a link to BENEFEDS.

When is my dental plan effective?

When enrolling during Federal open season, effective date will be January 1st. If enrolling outside of open season, effective date is the first day of the next pay period.

How does the Federal Advantage Plan work?

The Federal Advantage Plan lists a copayment for each dental procedure (see Copayment Schedule). You know exactly how much your dental services will cost. There are no deductibles and you have $15,000 annual maximum. You are free to see any Federal Advantage network dentist or specialist at any time.

How do I select a dentist?

The Federal Advantage Plan does not require that you pick a dentist in advance. You can see any participating dentist at any time. For a list of current Federal Advantage network dentists, please go to the Dentist Locator.

What if I want to change dentists?

You can go to any of the Federal Advantage network dentists at any time. All you have to do is look at the list of Federal Advantage network dentists and make an appointment with the one you think will be best for you. For a list of current Federal Advantage network dentists, please go to the Dentist Locator.

How do I make an appointment with my dentist?

Making an appointment is easy. All you have to do is look at the list of Federal Advantage network dentists and make an appointment with the one you think will be best for you. For a list of current Federal Advantage network dentists, please go to the Dentist Locator.

How do I know if my dentist is in the network?

You can always look at an up-to-date list of the Federal Advantage network dentists by going to the Dentist Locator.

What do I do if I need specialist care?

The Federal Advantage Plan includes coverage for specialty care. You can go to any one of the Federal Advantage network specialists in this affordable plan. No referral is required, and you'll know in advance the cost of all the procedures upfront.

How much will this plan cost; what will my premium be?

The premiums that will be deducted from your paycheck vary based on where you are located and how often you are paid. Go to the Premium Calculator to see exactly what your premiums will be.

Who is responsible for filing dental claims with the Federal Advantage Plan?

One of the many advantages to being a member of the Federal Advantage Plan is that you do not file any claims. You pay the amount listed in the Copayment Schedule (PDF) for the specific procedures you need done.

What do I do if I have a dental emergency?

Humana believes that your Federal Advantage network dentist will be the person most qualified to help you in an emergency, but if you are far from home, and an Federal Advantage network dentist is not available, you can get emergency care for pain relief right away. You can then see your Federal Advantage network dentist when you return home.

Do I have coverage if I go out of the state?

Federal Advantage Plan dental members can go to any participating Federal Advantage dentist. Your copayments at the dentist's office are the same in every state, no matter which Federal Advantage network dentist or specialist you choose. For a list of current Federal Advantage network dentists, please go to the Dentist Locator.

Do I have coverage if I go out of the country?

If you are outside the United States, you can get emergency care for pain relief right away. You can then see your Federal Advantage Plan network dentist when you return home. There are no Federal Advantage network dentists practicing outside of the continental United States.

Are my dependents eligible?

When you enroll in the Federal Advantage Plan, you will have the option to include family members. It's an important feature for families since out-of-pocket expense for dental care can grow quickly.

Are pre-existing conditions covered?

The Federal Advantage Plan covers pre-existing conditions. In addition, you can see a list of what you will pay for each dental procedure, so you can get an idea of how much money you will save when you enroll in this affordable plan. You can review the list of procedures by going to the Copayment Schedule (PDF).

Will this plan coordinate with other dental coverage?

The plan will coordinate benefits with your FEHBP medical carrier if embedded dental coverage exists. The plan does not coordinate benefits with any other dental insurance plan.

Do I have to enroll in a medical plan to get dental benefits?

All eligible federal employees and annuitants can purchase the Federal Advantage Plan for dental coverage. There is no requirement that you enroll in other FEHB sponsored plans. To enroll, you must sign up for the plan at www.BENEFEDS.com.

If I do not enroll now, will I have a chance to enroll in a dental benefits plan in the future?

If you are eligible now, you should sign up for the Federal Advantage Plan during Open Season. If you have a life-status change that would cause you to adjust your coverage, like getting married or having a child, you will have the opportunity to alter your coverage within 60 days of that status change.

Will I receive dental identification cards from Humana?

Yes, an identification card is included in your Welcome Packet when you enroll in the Federal Advantage Plan. The packet also includes instructions about how to use your new Federal Advantage plan.

Can I add family members during the contract year?

If you are eligible now, you should sign up for the Federal Advantage Plan during the Open Season for federal employees. If you have a life status change that would cause you to adjust your coverage, like getting married or having a child, you will have the opportunity to alter your coverage within 60 days of that status change.

Is there a waiting period before I can use my benefits?

No.

Are orthodontics covered for both children and adults?

Yes, the Federal Advantage Plan provides orthodontic services for adults (beginning in 2014) and children. Like every other dental procedure in this affordable plan, you know exactly how much you will pay because it is listed on the Copayment Schedule (PDF).

What is the waiting period for orthodontia?

None

I am currently wearing braces. How will my dental benefits work?

It is always best to discuss any change to your treatment plan with your orthodontist. You should review the Federal Advantage Plan with your orthodontist before you make any decisions about coverage.

What if I want to go to a dentist that is not in your network?

The only way to take advantage of the rich plan benefits is to receive care from a dentist who has agreed to work with the Federal Advantage program. You can review the list of Federal Advantage network dentists in your area by going to the Dentist Locator.

Does Humana cover implants?

Humana will cover implants beginning January 2014. Please refer to your Contract Brochure for details.