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Your Dental Plan Options
You may elect dental coverage for yourself and your eligible family members. You pay for this coverage with pretax dollars deducted from your paycheck. You may choose from two options:
1. Aetna DMO® (Dental Maintenance Organization)
With Aetna DMO, you choose a primary care dentist from Aetna's network to provide dental care, and you pay a percentage of covered expenses at the time of service. If you receive care from another dentist, you pay the entire cost out of your own pocket.
2. Aetna Dental PPO (Preferred Provider Organization)
With Aetna Dental PPO, you may receive care from any dentist. However, you will pay lower, negotiated fees when you use Aetna network dentists. For basic and major care, you first meet a deductible each year, then the plan pays a percentage of covered service. You must file a claim for benefits if you use an out-of-network dentist.
Dental Plan Comparison Chart
| Plan Feature |
Aetna DMO |
Aetna Dental PPO |
| Primary care dentist (PCD) |
Required |
Not Required |
| Deductible (individual/family) |
$0 |
$50/$150 |
| Provider network |
Yes |
Yes |
| Annual benefit maximum (for diagnostic and preventive, minor restorative, and/or major restorative services) |
Not applicable |
$2,000 per person |
| Orthodontia lifetime benefit maximum |
Not applicable |
$1,500 per covered child |
| Plan Pays* |
Coordinated by PCD |
Not coordinated by PCD |
May receive services from any dental provider but will pay lower fees with network providers. |
| Preventive care |
100% |
Not covered |
100% |
| Basic care |
90% |
80% after deductible |
| Major care |
60% |
60% after deductible |
Orthodontia treatment
(for children only) |
50% |
50% |
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*Out-of-network provider coverage is subject to reasonable and customary limits.
For additional information, please visit the Aetna Web site or review the DMO or the PPO benefit summaries.
A healthier smile, a healthier you is an informational brochure about the connection between good oral health and your overall health. Learn how, as the gateway to the body, the mouth can be the first line of defense against challenges to your health.
You may also wish to visit Simple Steps To Better Dental Health®, a premier dental health information resource provided in association with Columbia University's School of Dental and Oral Surgery. The site includes information on more than 55 dental conditions and treatments, an "Ask the Dentist" feature, and much more.
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