2021 Dental HMO
You’ll select a primary care dentist to provide your dental care. Copays are specified, so costs will be more predictable.
Voluntary benefits
Dental
Katy ISD offers two dental plans. While both pay 100% of the cost for preventive care, the plans differ in coverages depending on the services you need and the dentist you see.
compare_arrowsCOMPARE YOUR DENTAL OPTIONS compare_arrowsFIND A NETWORK PROVIDER
- Coverage is provided by Guardian. When you sign up for this plan, you must choose a primary care dentist (PCD). To do that, visit the GuardianAnytime. , click Find a Dentist and choose TX DHMO as your plan.
- Your plan fully covers most preventive care, such as routine checkups and cleanings. You and your covered dependents can receive up to two cleanings each 12-month period, free of charge.
- Generally, there are no deductibles to pay or claim forms to file. You simply pay the set copays when you receive covered services.
- If you need specialty dental care, your PCD is responsible for completing the necessary paperwork for a referral. For more information, please refer to the specialty referral process.
- Some services that are done to improve the look of your teeth, such as teeth whitening, may not be covered by your plan.
- You are covered for dental emergencies. Contact your PCD within 24 hours for emergency care or a referral to an alternate network dentist. Most PCDs have after-hours emergency services. If you can’t reach your PCD or you’re more than 75 miles from your PCD, call Guardian for a referral.
- If you’re out of town and need out-of-network emergency dental care, you must obtain pre-authorization from Guardian. You must notify your PCD and, in this case, submit a claim form for reimbursement of the plan amount for relief of pain only.
- You can use your health care flexible spending account to pay copays.
- You can change your PCD at any time. You must make the change by the 20th day of the month to have access to your new PCD on the first day of the next month.
Helpful resources
Have questions? Call Guardian 800-273-3330 for DHMO or Visit www.GuardianAnytime.com.
| Rates per pay period | |
|---|---|
| Based on 24 pay periods | |
| Employee | $7.27 |
| Employee + spouse | $13.62 |
| Employee + child(ren) | $10.35 |
| Employee + family | $17.79 |
| Annual deductible | |
|---|---|
| Individual | $0 |
| Family | $0 |
| Annual benefit maximum | |
|---|---|
| Unlimited | |
| Covered services | You pay |
|---|---|
| check Preventive | $0 - $5 |
| check Basic care | $10 - $80 |
| check Major care | $12 - $300 |
| check Orthodontia | |
| 24-month course of treatment: | Child $2,100 / Adult $2,200 |
2021 Dental PPO
You’ll pay a deductible for basic, major and orthodontic care.
- The Dental PPO plan, offered through Guardian, pays preventive care at 100%.
- You pay a deductible for basic, major and orthodontic care.
- This plan allows you to visit any dentist you choose.
- After you meet your deductible, you pay a percentage of covered expenses and Guardian pays the rest.
- You don't submit claims unless you use an out-of-network provider.
- You can use your health care flexible spending account to pay deductibles and coinsurance.
Finding a dentist
You can use any dentist you choose; however, your costs are lower if you use an in-network dentist. If you’d like to find an in-network dentist prior to enrolling in this plan, visit GuardianAnytime or call Guardian at 800-541-7846.
Helpful resources
Have questions? Call Guardian at 800-541-7846 for PPO or Visit www.GuardianAnytime.com.
| Rates per pay period | |
|---|---|
| Based on 24 pay periods | |
| Employee | $24.00 |
| Employee + spouse | $48.71 |
| Employee + child(ren) | $43.68 |
| Employee + family | $61.56 |
| Annual deductible | |
|---|---|
| Individual | $50 |
| Family | $150 |
| Annual benefit maximum | |
|---|---|
| $1,000 Individual | |
| Covered services | You pay |
|---|---|
| check Preventive | $0 |
| check Basic care | 20% of covered expenses after annual deductible |
| check Major care | 50% of covered expenses after annual deductible |
| check Orthodontia | |
| 24-month course of treatment: | 50% of covered expenses after deductible, up to $1,000 individual lifetime max |
Who do you want to cover?
| 2021 Dental HMO | 2021 Dental PPO | |||
|---|---|---|---|---|
| Rates per pay period | ||||
| $7.27 | $24.00 | |||
| Annual deductible | ||||
|
Individual $0 Family $0 |
Individual $50 Family $150 |
|||
| Annual benefit maximum | ||||
| Unlimited | $1,000 Individual | |||
| Covered services | ||||