Aetna Individual Advantage Dental has two plans to meet your needs — the Aetna Individual Advantage^SM Dental PPO Plan and the Aetna Individual Advantage^SM Dental PPO Plus Plan. They both offer coverage for:

• Preventive care services such as cleanings, x-rays and more
• Basic care like fillings, simple extractions, root canals, basic restorative work and more
• Major services such as bridges, crowns, dentures and more

If you are interested in one of these plans, print out an application , fill it out completely and send it to us at the following address:

Aetna Advantage Dental Plans, U22N

P.O. Box 730

Blue Bell, PA 19422

Monthly premium costs 
How much these plans cost (your monthly premium) is also different. Premium differences are based on the state (zip code) you live in.

Please select your state: 

• Arizona
• Delaware
• Illinois
• Pennsylvania

Choose any dentist

Both plans offer you the freedom to visit any dentist you choose. But you may find that you save money when you visit in-network dentists rather than out-of-network dentists.

You can visit a dentist who participates in the Aetna network (also known as a participating or in-network dentist). You can also visit a dentist who does not participate in the network (also known as a nonparticipating or out-of-network dentist).

In-network dentists have agreed to provide services to Aetna members at a negotiated (discounted) rate. They will charge the discounted rate for services covered by these two plans, as well as for non-covered services such as cosmetic tooth whitening and orthodontic care.

So, you generally pay less out of your own pocket when you visit in-network dentists — because the percentages you pay for the care you receive are based on those discounted rates.

It is easy to find a participating or in-network dentist in your area. Visit our online DocFind® directory.

While in-network dentists accept the negotiated fee in full, out-of-network dentists generally do not. As a result, you will end up paying more for their services. You may be subject to balance billing — the dentist may bill you to make up for the difference between their standard fee and what the plan pays.

What’s different between the two plans?
The difference in plans is in the amount each plan pays for covered services. Check out the following table to see the types of services covered and the percentage of those services paid by each plan.

Keep in mind: While the level of benefits is the same for in-network and out-of-network dentists, what the plan pays for covered out-of-network services is a percentage of the negotiated rate with in-network dentists in the applicable geographic area — not a percentage of the standard fee charged by out-of-network dentists.

	Aetna PPO Plus Plan pays*	Aetna PPO Plan pays*	Waiting Period
Diagnostic and preventive	100%	80%	None
Periodontal maintenance cleanings	80%	50%	6 months
Denture repair, rebase and relining	80%	50%	6 months
Basic restorative (fillings)	50%	50%	6 months
Oral surgery	50%	50%	6 months
Endodontics (root canals)	50%	50%	6 months
Additional coverage
Periodontics	50%	50%	18 months
Crown and cast restorations	50%	50%	18 months
Prosthodontics (dentures)	50%	50%	18 months
Temporomandibular joint (TMJ) dysfunction	Not covered	Not covered	Not covered
Deductibles and maximums per member enrolled
Deductible (calendar year)	$50	$100
Maximum benefit (calendar year)	$1,200	$1000

Above list of covered services is representative.

*Out-of-network coverage is limited to a maximum of the plan’s payment, which is based on the negotiated, contract rate for in-network providers in a particular geographic area.

** Discount programs are rate-access programs and may be in addition to any plan benefits. Discount and other similar health programs offered hereunder are not insurance and program features are not guaranteed under the plan contract and may be discontinued at any time. Program providers are solely responsible for the products and services provided hereunder. Aetna does not endorse any vendor, product or service associated with these programs. It is not necessary to be a member of an Aetna plan to access the program participating providers.