Dental

DENTAL COVERAGE

You have three dental plan options. All are offered through Aetna and cover preventive care, basic care, major care, and orthodontia. The options include:

  • Aetna Managed Dental Plan (DMO), which pays benefits only when you use network providers
  • Aetna PDN (Low Option), which pays benefits in- and out-of-network.
  • Aetna PDN (High Option), which pays benefits in- and out-of-network

dental-network

For a list of Aetna dental network providers, go to www.aetna.com. Click here for instructions on how to locate a dental provider.

No ID Card Needed! You do not need a member ID card to get care with Aetna Dental. When you go to your dentist, just tell the office your name, date of birth, and Member ID# (or your social security number). If you would prefer to have a card, you may print one at www.aetna.com.

Accessing DMO services will be quicker if you designate a primary care dentist when you enroll.

Summary of Coverage

The table below summarizes how each plan covers dental expenses and shows what each plan pays. 

Plan Feature Aetna Managed Dental Plan (DMO) In-Network only Aetna PDN (Low Option) In-Network and Out-of-Network1 Aetna PDN (High Option) In-Network and Out-of-Network2
Deductible None $50 per person $150 per family $50 per person $150 per family
Preventive Care: One visit every six months for routine checkups, X-rays, cleaning, and polishing You pay a $5 copay

You pay 10% with no deductible

 

 You pay $0
Basic Care: Fillings, extractions, root canal therapy, scaling of teeth, and basic oral surgery You pay a fixed copay according to the plan’s schedule You pay 40% after deductible You pay 20% after deductible

Major Care: Bridges, dentures, crowns, inlays, onlays, and complex oral surgery

 You pay a fixed copay according to the plan’s schedule You pay 60% after deductible

You pay 50% after deductible

*Implants are included in Major Care for this plan option
Maximum Annual Benefit No limit $1,000 per person $1,500 per person
Orthodontic Care3 You pay a $2,300 copay 50% with no deductible; $1,000 lifetime maximum

50% with no deductible; $1,500 lifetime maximum

1 For the PDN (Low Option), fees are based on Aetna’s fee schedule, so your out-of-pocket expenses will be higher than those under the PDN (High Option).

2 Dental PDN network providers agree to charge discounted rates for their services. Although the coverage is the same for in-network and out-of-network care, out-of-network providers may charge higher fees than in-network providers, resulting in higher out-of-pocket expenses for you.

3 For eligible adults and dependent children.

Download the Aetna app on your mobile device to view claims, find a dentist, and access a variety of resources.
Aetna

 

Dental Plan Summaries

Additional Information

Who do I contact with questions?