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Dental Plan Grid

Dental Maintenance Organization (DMO®) and Aetna Advantage Plus Dental
Primary Care Dentist (PCD) Selection Required Referrals Required Stay in Network for Highest Coverage Levels
Check Check Check

Summary
With the Dental Maintenance Organization (DMO®) and Aetna Advantage Plus Dental plan, you are covered for a broad range of covered services with no deductibles or annual maximums to meet (copayments may apply). In order to take advantage of covered benefits you must select a participating primary care dentist. You and each member of your family can select a different participating primary care dentist who is the key to your dental care. Your primary care dentist provides and coordinates your care, referring you to participating dental specialists as appropriate under the terms of your plan.

Aetna Advantage™ Dental
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
Check No Check

Summary
As an Aetna Advantage™ Dental plan member, your primary care dentist is key to your dental care. You'll pay a low office visit copayment when you visit your participating primary care dentist for most preventive and diagnostic services such as routine checkups, cleanings, X-rays or, for members under 18 years of age, fluoride treatments. Specialty care is available at reduced fees and members may directly access participating specialists.


Basic Dental
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
Check No Check

Summary
As an Aetna Basic Dental plan member your participating primary care dentist is key to your dental care. You'll pay just a small copayment when you visit your participating primary care dentist for a routine checkup, cleaning, fluoride treatment (for people under age 18) and amalgam restorations (fillings). Specialty care is available at reduced fees and members may directly access participating specialists.


Family Preventive
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
Check No Check

Summary
As an Aetna Family Preventive plan member your participating primary care dentist is key to your dental care. You'll pay a small copayment when you visit your participating primary care dentist for a checkup, routine cleaning, or fluoride treatment (for children under age 18). If you require other covered dental services, your primary care dentist will offer them to you at a reduced fee. Specialty care is available at reduced fees and members may directly access participating specialists.


Discount Dental
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
Check No Check

Summary
With the Discount Dental plan, you can take advantage of comprehensive dental services for reduced fees -- up to 20%-30% off standard fees -- when you use a participating dentist. A current reduced fee schedule is available for review from network dentists. All reduced fees for dental services must be paid directly to the network dentist at the time the service is performed.


Dental PPO/PDN
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
No No No

Summary
A dental preferred provider organization (PPO) works much like a traditional dental plan - you choose the dentist you want and pay deductible and coinsurance up to an annual maximum. But with our PPO plan, you'll generally save on the cost of your dental care when you use a dentist who participates in our network because your coinsurance is applied to a negotiated rate.

Please Note: In Texas, the Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN).


Aetna HealthFund® with Dental/Aetna DentalFund®
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
No No No

Summary
Aetna HealthFund® with Dental/Aetna DentalFund® are a consumer-directed family of products that combine a PPO or indemnity plan with an employer-paid health fund. They offer the comprehensive coverage of a traditional dental plan, plus a unique health fund benefit that allows you to choose the covered dental services you want from your choice of dentists.

Please Note: In Texas, the Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN).


Aetna Dental Access®/Vital Savings by Aetna®
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
No No Check

Summary
Vital Savings by Aetna® is a referral only plan - it is not an insurance plan. When members need care, they may visit any Aetna Dental Access® participating dentist to access discounted dental services. At the time the service is performed, the member pays 100% of the PPO/PDN maximum fee schedule amount for the service.


Exclusive Provider Plan (EPP)
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
No No Check

Summary
The Exclusive Provider Plan (EPP) is like the PPO/PDN in that it uses the same fee schedule and claims submission processes. However, with the EPP plan, members do not receive coverage for non-emergency care provided by a non-participating dentist. Currently, the EPP is being offered only on a self-insured basis. Members with ID cards that say “EPP” should be billed in accordance with the PPO/PDN fee schedule.


Affordable Health Choices from AetnaSM
Primary Care Dentist (PCD) Selection Required Referrals Required Must Stay In-Network
No No Check

Summary
Affordable HealthChoices is an insurance product designed for small companies and their employees to help reduce the number of working uninsured people in America. As a part of the Affordable HealthChoices plan design, Aetna offers a dental referral plan. A member can select a participating general dentists or specialist and receive services at a reduced fee. The members must inform the dentist or show their ID card to receive the reduced fee.



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