Aetna DMO
A no-premium cost dental plan including coverage for orthodontia. Participants must select a dental office to be assigned to. Coverage is only available through a network provider.
Dental Plans
You can enroll in the dental plan of your choice as a new hire, during Open Enrollment, or if you experience a qualifying life event. Premiums are available in Employee Central.
Aetna DPPO
A premium cost sharing dental plan including coverage for orthodontia. Participants have the flexibility to go to the provider of their choice.
Key Features at a Glance
Our dental coverage provides:
Free in-network preventive and diagnostic care
to help keep your teeth healthy
Affordable coverage
that helps you manage the cost of dental treatment
Wide network of providers
that have agreed to negotiated rates, which helps you save money
Find a Network Dentist
You may choose to see any in- or out-of-network dentist you’d like, but you’ll generally pay less when you stay in network. Visit the Aetna website to find an in-network provider near you.
Coverage Details
| In-Network Benefits* | Aetna DPPO | Aetna DMO |
|---|---|---|
| Individual/family deductible | $50/$150 | No deductible |
| Annual maximum benefit | $1,500 | No annual maximum |
| Services | ||
| Preventive | You pay $0 | Refer to copay schedule |
| Basic | You pay 20%, plan pays 80% | Refer to copay schedule |
| Major | You pay 50%, plan pays 50% | Refer to copay schedule |
| Orthodontia (coinsurance/lifetime maximum) | Plan pays 50% up to a lifetime maximum of $2,000 | Refer to copay schedule |
*Note: If you visit an out‐of‐network provider, the fee schedule will be different and you may be responsible for any charges above the usual, customary, and reasonable (UCR) limits.
Use Your Dental Benefits Wisely
Here’s how to make the most of your dental benefits:
Choose a network provider.
Each time you need dental care, you have a choice of providers. Selecting a Aetna participating dentist will ensure you receive the highest benefits from your plan. To find a provider, go to the Aetna website.
Present your plan identification.
Give your provider's office the information they need to bill your insurance. The group number is 885560 and your member number is your Social Security number.
Submit for a pretreatment estimate.
You should submit a request for a pre-treatment estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, call Aetna at 1-877-238-6200 or visit the Aetna website.
Check your claim status.
You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more on the Aetna website.