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HMO Dental
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Dental

A bright white smile is important for your bubblegum card. The city offers you two affordable options to help keep your mouth healthy. Rates remain the same as last year for the DHMO, but increase 9 percent in the indemnity plan

Dental contributions
  Retiree monthly cost
DHMO
Self only $9.00
Self + 1 $19.40
Self + 2 or more $27.46
Dental Indemnity
  From To
Self only $27.24 $29.70
Self + 1 x $63.00 $68.68
Self + 2 or more $85.90 $93.64

 

DHMO

A dental health-maintenance organization is a network of dentists, like an HMO, that offers a comprehensive range of dental services for fixed copayments. You choose a primary-care dentist who coordinates your care and refers you to specialists. You must live in the service area to enroll. The DHMO is provided by National Pacific Dental.

Features of the DHMO include:

  • No maximum annual limit on dental services
  • No deductibles
  • No claim forms to complete for most procedures
  • A fixed copayment for dental services
  • A network that includes dentists and orthodontists

 

Dental-indemnity plan

A dental-indemnity plan is a traditional plan that lets you receive a comprehensive range of dental services from the provider of your choice anywhere in the United States. You pay a percentage of charges for certain services and file a claim for reimbursement. The plan is provided by UnitedHealthcare Inc.

How you use the plan:

  • Make an appointment with the dentist of your choice.
  • If the treatment will cost more than $200, get an estimate.
  • Get a claim form from the Human Resources benefits division.
  • Pay the dentist. Some dentists only require patients to pay their portion.
  • File a claim for reimbursement within 90 days of the date of service. Some dentists will file your claim for you.
  • Mail the claim to: UnitedHealthcare Inc., 1445 North Loop West, Suite 500, Houston, Texas 77008
  • Reimbursement is made by mail, usually within 10 days.
  • To check on the status of a claim, call 866-605-2599.

For a complete list of services, refer to the City of Houston Dental Indemnity Plan brochure.

In-network preferred dentist option
 If you are enrolled in the dental-indemnity plan, you can reduce your out-of-pocket costs by using a preferred dentist. If you receive care from a preferred dentist or network of dental providers, you will receive a discount on your services and have more money in your pocket.

As you can see in the chart below, if you use a preferred dentist, you will realize a considerable savings. The more costly the dental work, such as bridges or dentures, the more savings you will realize. Also, because all fees are reduced, you will receive more services before you reach the $1,500 annual maximum benefit.

Example savings using a
preferred dentist
Plan Usual cost 50% coinsurance
Out-of-network $875 $437.50
In-network $701 $350.50
Your savings $87

 

 

 

 

 

  
 
 
 
 
 

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If there exists a conflict between this Enrollment Guide Website and the official plan documents for each plan, the official plan documents will prevail. The city of Houston reserves the right to change, modify, increase or terminate any benefits.