UnitedHealthcare Dental HMO (Dental Direct) is unique for a DHMO dental plan. You are not required to select a provider as long as you and your dependents go in-network. If you receive services from a provider outside of the approved network, you would be responsible for paying the entire dental bill yourself.
To find a UnitedHealthcare Dental HMO dentist, go to www.myuhc.com and select Find a Dentist, or call 800.999.3367.
Part-time employees are eligible to enroll in the UnitedHealthcare Dental HMO plan only.
Dual Coverage Not Allowed for the Same Dental Plan
If both you and your spouse are an employee of Fresno Unified School District and qualify for coverage as a Primary Enrollee, neither of you may enroll as a Dependent of the other for the same dental plan. In addition, only one of you may enroll your dependent child(ren) for the same dental plan. However, if you and your spouse enroll in separate dental plans (i.e., one enrolls in Delta Dental and the other enrolls in UHC), you may cover your spouse and dependent child(ren) in each plan.
Plan Highlights
United Healthcare Dental HMO
Annual Calendar Year Deductible
In-Network Only
Per Person
N/A
Family Maximum
N/A
Calendar Year Maximum
N/A
Preventive Services
In-Network Only
Office Visits
No Charge
X-rays
No Charge
Cleanings
No Charge
Sealants (per tooth)
$5 Copay
Restorative Services
In-Network Only
Amalgam Fillings
No Charge
Composite Fillings
$0-10 Copay
Periodontics (gum treatment)
In-Network Only
Scaling & Root Planning
No Charge
Gingivectomy (4+ teeth)
No Charge
Endodontics (root canal therapy)
In-Network Only
Pulpotomy
No Charge
Root Canal
$0 – $60 Copay
Oral Surgery
In-Network Only
General Anesthesia
$10 Copay
Simple Extraction
No Charge
Soft Tissue Impaction
$17 Copay
Complete or Partial Bony Impaction
$23 – $30 Copay
Crowns & Inlays
In-Network Only
Inlay / Only (2 surfaces)
Copay varies on treatment
Crowns
$7 – $73 Copay
Prosthetics & Bridges
In-Network Only
Bridges
$0 – $80 Copay
Denture Adjustment
$0 – $10 Copay
Complete or Partial Denture
$63 – $93 Copay
Other Services
In-Network Only
Implants
$1,950 Copay
Orthodontia Services
In-Network Only
Child / Adult Orthodontia Phase 1 & 2
$2,000 maximum out-of-pocket expense for 24-month treatment plan
(1)Resin, porcelain and any resin to metal or porcelain to metal crowns and pontics are excluded on molar teeth. If titanium, noble or high noble metals are requested for filings, crowns, pontics, bridges or prosthetic devices, there will be an additional charge, based on the amount of the metal used. Flexible base partial dentures are subject to an additional charge based on additional laboratory cost.
The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions down below.
