Dental Plans

Dental plans in select states

Aetna offers stand-alone plans in select states only, as well as through some employer plans. To determine if you can purchase a stand-alone plan in your state, please visit Dental Insurance from Aetna. If you have Aetna Dental insurance through an employee plan or are being offered Aetna Dental insurance through work, visit Plans through Work.

If you are ready to purchase, we have three dental benefits and insurance plan types, each with their own advantages in terms of value, service and coverage options.

Aetna Dental Plans

Dental Maintenance Organization (DMO®)

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A DMO tends to be a lower-cost dental benefits and insurance plan. You choose a primary care dentist (PCD)**. If your plan covers orthodontia, you do not need a referral to see a DMO orthodontist. There are no deductibles or annual maximums. 

View our DMO video 

Preferred Provider Organization (PPO) or Participating Dental Network (PDN)**

Little boy brushing his teeth

With Dental PPO or PDN insurance plans, you can visit any dentist you want. You never need a referral. But costs usually are lower if you choose a dentist who is part of the network. Deductibles and annual maximums may apply. 

View our PPO video

Dental indemnity***

Two guys on a basketball court

A dental indemnity insurance plan gives you free choice of any dentist you want. There may be deductibles and annual maximums with these plans, too.

Compare the three types below:

 

DMO

Dental PPO or PDN

Dental indemnity

Plan description

A lower-cost dental benefits and insurance plan that gives you cost-effective care through a primary care dentist (PCD). You get the advantage of building a relationship with your PCD.

Visit any licensed dentist to receive benefits. You will typically enjoy lower costs if you choose a dentist who participates in our PPO/PDN network. There is never a need for a referral.

The freedom to visit any licensed dentist, anywhere in the country. No need to choose a PCD.  There is never a need for a referral.

Plan options

Copay – You pay a set dollar amount at the time of service.

OR

Coinsurance – You pay a percentage of covered expenses at the time of service.

Coinsurance – You pay a percentage of covered expenses at the time of service.

Coinsurance – You pay a percentage of covered expenses at the time of service.

Primary care dentist

Yes – Call the dentist to ensure he or she is accepting new patients.

Not required

Not required

Office visit copay

$0 to $15 depending on your plan.

None

None

Deductible

None – There is just a copay to pay. You do not have a plan deductible.

Yes – There is a deductible for procedures not covered at 100%. That means you pay a dollar amount before the plan starts to pay.

Yes – There is a deductible for procedures not covered at 100%. That means you pay a dollar amount before the plan starts to pay.

Annual maximum

None – Aetna DMO plans do not have an annual maximum limit. The plan continues to pay benefits for covered procedures throughout the plan year.

Yes – There are limits to how much Aetna will pay in benefits for covered procedures in a plan year.

Yes – There are limits to how much Aetna will pay in benefits for covered procedures in a plan year.

Referrals

Referrals are required, except when you visit an orthodontist in our DMO network.

None required

None required

Procedures not covered by the plan

You are responsible for the cost of procedures not covered by your plan.

You are responsible for the cost of procedures not covered by your plan. But remember this: Participating PPO and PDN dentists offer discounts on procedures not covered by your plan.

You are responsible for the cost of procedures not covered by your plan

Next step

It's easy to find a participating dentist. Just visit our online directory.

*State laws vary with regard to out-of-network benefits.  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 participating primary care dentist.  Illinois DMO is not an HMO. In California, your dentist may refer you to out-of-network dentists for some services. Check your plan documents for details.

**Your PCD keeps a list of eligible patients that is updated monthly. Your name will appear on this list when it is updated the month after your selection. Some dentists will only treat patients who appear on this printed monthly roster. Call the Member Services number on your Aetna ID card if your dentist needs to confirm your eligibility.

***Benefits for the indemnity plan are paid based on usual and prevailing charges or recognized charges levels, as determined by Aetna and specified in your plan.

Dental benefits and dental insurance plans are offered, underwritten and/or administered by Aetna Dental Inc., Aetna Dental of California Inc., Aetna Health Inc. and/or Aetna Life Insurance Company, and in Texas by Aetna Dental Inc., and in Arizona by Aetna Health Inc. The Dental PPO Plan is underwritten by Aetna Life Insurance Company (Aetna)

This material is for information only and is not an offer or invitation to contract. An application must be completed to obtain coverage.  Rates and benefits vary by location.  Dental providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to dental services. Dental benefits and dental insurance plans contain exclusions and limitations. Not all dental services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and/or group size and are subject to change. For self-funded accounts, benefits coverage is offered by your employer, with administrative services only provided by Aetna Life Insurance Company. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com.

If you need this material translated into another language, please call Member Services at 1-877-238-6200. Si usted necesita este documento en otro idioma, por favor llame a Servicios al Miembro al 1-877-238-6200.

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