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UnitedHealthcare Dental Plans

 

​Harris County employees have the option of choosing either a DHMO Plan or PPO Plan for their dental care. You must choose one plan during each annual open enrollment and no plan changes can be made until the next open enrollment.

  • Review the plans and decide which fits your needs best: DHMO or the PPO Plan.
  • If you select the DHMO Plan, choose a participating dentist from the directory of dental providers.
  • Remember that the dependents you enrolled in the medical plan will be covered under the dental as well. Each family member may choose a different provider.
  • If you select the PPO Plan you must file a claim for reimbursement.

 

Dental DHMO PLAN

 

​First, you must select a dentist who is affiliated with UnitedHealthcare Dental. A list of these dentists can be obtained from your department's Benefits Coordinator, or online at www.yourdentalplan.com/harriscounty. When specialty care is required, your selected general dentist will provide you with a referral prior to receiving this treatment.

Standard covered services with little or no copayment:

  • Examinations and x-rays
  • Two basic cleanings each year
  • Pulp vitality tests
  • Partial or denture adjustments
  • Orthodontic consultations
  • Fluoride treatment
  • Diagnostic consultations
  • Crowns recemented
  • Wellness screenings
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(866) 528-6072Dental
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(866) 528-6072Dental
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 Dental Documents

 Quick Links

Services that are NOT COVERED:

  • Services of dentists not associated with this Plan
  • Hospitalization for any dental procedure
  • Experimental procedures
  • Prescription and non-prescription drugs
  • Oral surgery to set a fracture or dislocation
  • Services for conditions already covered under Workers' Compensation
  • Implants and implant-related products
  • Temporomandibular Joint (TMJ) Dysfunction (medical)
  • Full mouth reconstruction

 

The Evidence of Coverage including schedule of benefits, exclusions and limitations is available on the Harris County Human Resources and Risk Management page under the "Dental Plan Documents" tab.

 

Dental PPO PLAN

 

​The PPO Plan is available through UnitedHealthcare Dental that gives you the freedom to select any dentist or specialty dentist for any appointment you schedule. In addition, you can choose a different dentist for each member of your family.

If you decide the PPO Plan is right for you, there is no need to "pre-register" with a dental care provider - you can receive treatment from any dentist. When choosing a dentist, remember that if you choose to receive care from a contracted UnitedHealthcare dentist, you could save on your out-of-pocket costs. Contracted dentists have agreed to accept the negotiated fee as payment in full with no balance billing.

Payment of claims is based on a Maximum Allowable Charge (MAC). The Maximum Allowable Charge is set by UnitedHealthcare and based on negotiated rates with contracted dentists. The MAC is the most that UnitedHealthcare will pay for a particular dental procedure under the plan.

Your Costs Payment of claims is based on a Maximum Allowable Charge (MAC). The Maximum Allowable Charge is set by UnitedHealthcare and based on negotiated rates with contracted dentists. This MAC is the most that UnitedHealthcare will pay for a particular dental procedure under the plan.

UnitedHealthCare Dental HMO
UnitedHealthCare Dental PPO
No calendar year maximums; no yearly deductibles
$1,750 calendar year maximum; $50 yearly individual deductible ($150 for family).
Basic care provided by network general dentists selected at enrollment. Members may change their designated dentist by contacting UnitedHealthcare Dental customer service by the 20th of the month. Requested changes will be effective the first of the following month.
You may receive care from any licensed dentist; network dentists have agreed to accept negotiated fees as payment in full with no “balanced billing”.
Each family member may select a different UnitedHealthcare Dental network general dentist (remember to include the Practice ID number when enrolling).
Non-network dentists could “balance bill”, which may result in higher out-of-pocket costs (see the Benefit Summary or determine out-of-pocket costs by using the online Treatment Cost Calculator for more information).
Covered procedures and copayments are listed on the Schedule of Benefits and may be found on www.yourdentalplan.com/harriscounty
All claims are paid based on the percentages of the Maximum Allowable Charge (MAC).
When specialty care is required, your selected general dentist and UnitedHealthcare Dental Customer Service Representative will assist in managing your referral.
If you require specialty care, you may see any specialty care dentist you choose. When you receive care from a network dentist, you may save on your cost of care.
No waiting periods.
New enrollees: 6 month waiting period on endodontic procedures & all major services (new employees and newly added dependents of current employees).

Adult & child orthodontics is included. ​​

Orthodontia is not a covered benefit in the PPO plan.

​​No claim forms are required.

Claim forms may be required when a non-network dentist is used.

*Benefits for the UnitedHealthcare Dental DHMO plans are provided by the following UnitedHealth Group company: National Pacific Dental, Inc.

**Benefits for the UnitedHealthcare Dental PPO plans are provided by UnitedHealthcare Insurance Company, located in Hartford, Connecticut

 

Customer Service

 

If you have questions regarding coverage, claims, or locating a dentist in your area, please contact the dental customer service department. The department can be reached at the toll-free number listed on your dental ID card – (866) 528-6072, Monday through Friday from 7:00 a.m. to 10:00 p.m., Central Time.

Through the same toll-free number, you may also choose to use the automated voice system. This provides access to dental information 24 hours a day, 7 days a week. Among many options, this system allows you to verify benefits, check the status of a claim, or obtain a pre-treatment estimate.