Dental Benefits
UnitedHealthcare offers DHMO and DPPO dental plans.
Dental Premiums
| Coverage Tier | DHMO Contribution | DPPO Contribution |
|---|---|---|
| Employee Only | $0.00 | $0.00 |
| Employee + Spouse | $7.06 | $13.78 |
| Employee + Child(ren) | $6.68 | $10.33 |
| Employee + Family | $14.54 | $24.60 |
Employee Only
- DHMO Contribution
- $0.00
- DPPO Contribution
- $0.00
Employee + Spouse
- DHMO Contribution
- $7.06
- DPPO Contribution
- $13.78
Employee + Child(ren)
- DHMO Contribution
- $6.68
- DPPO Contribution
- $10.33
Employee + Family
- DHMO Contribution
- $14.54
- DPPO Contribution
- $24.60
Coverage Details
| Feature | DHMO In-Network | DPPO In-Network | DPPO Out-of-Network |
|---|---|---|---|
| Deductible (Individual/Family) | None | $50 / $150 | $50 / $150 |
| Annual Benefit Maximum (per person) | None | $1,500 | $1,500 |
| Preventive Services | No charge | No charge | 20% |
| Basic Services | See copay schedule in ADP | 20%* | 40%* |
| Major Services | See copay schedule in ADP | 50%* | 60%* |
| Orthodontic Services (Child & Adult) | $2,185 Copay | $1,250 Max Benefit | $1,250 Max Benefit |
Deductible (Individual/Family)
- DHMO In-Network
- None
- DPPO In-Network
- $50 / $150
- DPPO Out-of-Network
- $50 / $150
Annual Benefit Maximum (per person)
- DHMO In-Network
- None
- DPPO In-Network
- $1,500
- DPPO Out-of-Network
- $1,500
Preventive Services
- DHMO In-Network
- No charge
- DPPO In-Network
- No charge
- DPPO Out-of-Network
- 20%
Basic Services
- DHMO In-Network
- See copay schedule in ADP
- DPPO In-Network
- 20%*
- DPPO Out-of-Network
- 40%*
Major Services
- DHMO In-Network
- See copay schedule in ADP
- DPPO In-Network
- 50%*
- DPPO Out-of-Network
- 60%*
Orthodontic Services (Child & Adult)
- DHMO In-Network
- $2,185 Copay
- DPPO In-Network
- $1,250 Max Benefit
- DPPO Out-of-Network
- $1,250 Max Benefit
- *Benefits with an asterisk ( * ) require that the deductible be met before the Plan begins to pay.
Important Notes
- The DHMO is only available in certain states. Availability will be reflected in ADP.
- You will select Exclusive Network Dental Plan when searching for a DHMO provider: https://www.whyuhc.com/endp
- To find a DPPO in-network provider, visit https://www.whyuhc.com/dentalppo and select: Search the Dental PPO 20 Network.
- Coinsurance percentages and copay amounts shown in the above chart represent what the member is responsible for paying.
- If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.