General dental FAQs

I enrolled in a dental plan at work. How do you know I am eligible?
Your employer gives us enrollment information.

Do I need to select a Primary Care Dentist? 
Dental Maintenance Organization (DMO®*) members must choose a primary care dentist. So do people who use our managed dental plans such as Basic Dental, Advantage Dental, and Family Preventive. Finding one is easy. Just visit DocFind®, our online provider directory.

Do I need a referral to see a specialist? 
Only DMO* plans require referrals. DMO* members, however, do not need a referral to see a participating orthodontist.

I'm enrolled in more than one dental plan. How does coverage work with two plans? 
We confirm which plan has primary responsibility for claim payment. If we have primary responsibility, we pay as the primary payor. If not, we pay as the secondary payor.
Here's an example: 

• Your spouse is offered coverage through his or her employer. Let's say your spouse is covered by your Aetna plan and his/her employer plan. 
• According to most plan rules, your spouse's employer's coverage is primary for your spouse. 
• That means your Aetna plan is the secondary payor for your spouse. 

Please note that there are several types of coordination of benefits provisions. They may differ by plan. Please contact member services for more information.

Are all dental services covered by my plan?
Your plan documents describe the services covered by your plan. See your employer benefits specialist if you need a copy.

Are composite fillings (white fillings) covered?
Please see your plan documents for coverage details. You may also call member services at the number listed on your member ID card.

Are there any restrictions in replacing missing teeth with dentures, bridges or implants? 
There are restrictions. Please see your plan documents for coverage details. You may also call member services at the number listed on your member ID card.

How often will my plan replace crowns, bridges and other devices? 
Please see your plan documents for coverage details. You may also call member services at the number listed on your member ID card.

Are there any restrictions as to how often a service can be performed? 
Yes. There are services that will have a frequency limitation. Please see your plan documents for coverage information. You may also call member services at the toll-free number listed on your member ID card.

How will I know if the treatment I need will be covered? 
The easiest way is to ask your dentist to send us a pretreatment estimate. This will let you and your dentist know what the benefit will be if the service is done. You or your dentist may also call member services at the toll-free number on your ID card.

I just enrolled in a dental plan and want to know more. Can I check my plan status online? What else can I do? 
Register for Aetna Navigator®, your secure member website. You will find great online tools to help you manage your dental care 24 hours a day, 7 days a week.

If you want up-to-date dental health information, visit Simple Steps To Better Dental Health. You'll find articles and facts on over 50 dental conditions and treatments. Or you can call our customer service staff for help, too. Our toll-free phone number is listed on the dental ID card you get after you enroll.

If you are a dental Indemnity insurance plan member, ask your employee benefits specialist for the number to call.

I heard dental plan members have access to discount programs. Where can I get more information?
For general facts, see member advantages. For details as a plan member, visit Aetna Navigator, your secure member website. It's available 24 hours a day, 7 days a week.

* In Illinois, DMO plans provide limited out-of -network benefits. However, in order to receive maximum benefits, members must select and have care coordinated by a participation primary care dentist. Illinois DMO is not an HMO.