Dental/Medical Integration Program

Research shows that up to 90% of whole-body illnesses can show their first signs in the mouth.¹  And gum disease may impact a healthy pregnancy.²  That's why we offer a program that provides outreach and enhanced dental insurance benefits to members who need it most.* It’s our Dental/Medical Integration program.

It's yours at no additional cost, if you offer an Aetna dental benefits or dental insurance plan with Aetna medical insurance benefits plans.

It’s industry leading

Our Dental/Medical Integration program offer eligible members customized education through mailers and phone calls.

We urge eligible members to call our dental care coordinators to:

• Enroll in our program
• Choose a dentist
• Get help making a dental appointment
  

We're having an impact

Thanks to our program, 56% of our at-risk members who did not get dental care before are getting it now.**

The program focuses on members who have not had a recent dental visit and are pregnant or have diabetes, heart disease and/or cerebrovascular disease. They can use the program without any extra paperwork.

No wonder so many eligible members are using the enhanced dental benefits available to them. These benefits are fully covered with no deductible. They include:

• One extra visit for a routine cleaning
• A dental debridement to remove any thick or hard deposits on teeth
• Dental office use of antibacterial agents to treat periodontal disease***
• Periodontal maintenance

We are thought leaders

Here's why:

• Our own research with Columbia University College of Dental Medicine shows that periodontal care may help lower medical costs for members with certain chronic conditions.
• Aetna is the first dental benefits and insurance company with a published study on the impact dental health has on medical claims.³
• We monitor member claims continuously. We reach out to members eligible for our Dental/Medical Integration program, disease management programs and more.

1 WebMD.com. "Oral Health: the Mouth-Body Connection" Available online at http://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection. June 2007. Accessed April 8, 2008.

2 Vergnes J-N, Sixou M. Preterm low birth weight and maternal periodontal status: a meta-analysis. American Journal of Obstetrics and Gynecology. 2007;196:135.e1-135.e7.

3 Albert DAA, Sadowsky D, Papapanou P, Conicella ML, Ward A.  An examination of periodontal treatment and per member per month (PMPM) medical costs in an insured population.  BMC Health Services Research 2006; 6:103.Continued analysis of retrospective study proves sustained results, Aetna Health Analytics, August 2008.

*Exclusions and limitations may apply. Refer to your plan documents for details. Treatment offered is based on member's dental evaluation. Dental/Medical Integration may not be available in all states.

** Based on 2010 dental PPO claim data.

***The localized delivery of antimicrobial agents is not included for pregnant  women due to physician concerns with antibiotics during pregnancy.

Dental benefits and insurance plans contain exclusions and limitations.DMO plans are underwritten by: Aetna Dental Inc. and/or Aetna Life Insurance Company; in California by Aetna Dental of California Inc; in Arizona and Georgia by Aetna Health Inc. PPO, PDN and indemnity plans are underwritten and/or administered by Aetna Life Insurance Company. Dental rider plans are underwritten by these Aetna health benefits and health insurance companies: Aetna Health Inc.; Aetna Health of California Inc.; Aetna Health of the Carolinas Inc.; Aetna Life Insurance Company; in Arizona by Aetna Health Inc. and/or Aetna Life Insurance Company (Aetna). In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT  06156.  Each insurer has sole financial responsibility for its own products.

This material is for information only and is not an offer or invitation to contract. An application must be obtained to obtain coverage. Rates and benefits vary by location. Dental information programs provide general dental information and are not a substitute for diagnosis or treatment by a dentist or other health care professional. 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 group size and are subject to change. 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 health/dental services. 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.

Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-9/GR-9N, GR-23 and/or GR-29/GR-29N.