Aetna DentalFund® Plan
Affordable dental care can be within reach
Members take a more active role in dental care with the Aetna DentalFund insurance plan.
Why Aetna DentalFund?
- Tax advantages – Dental insurance fund dollar contributions are not considered taxable income.
- Plan options – The base dental plan may be a Preferred Provider Organization plan (PPO)* or an indemnity dental insurance plan.
- Choice – Choose the deductible, coinsurance and fund amounts that work best.
- Flexibility – The DentalFund offers the option to reimburse certain non-covered procedures.
- No referrals – Members can visit any licensed dentist.
Any amount paid from a fund counts toward a member’s deductible
For instance:
- If a member’s fund contains $200, and the deductible is $175, the member will have “paid” all of the deductible after spending $175 from the fund.
- After a member pays the deductible, he or she will pay a percentage of costs. This percentage is called coinsurance. The fund will cover this amount, as long as there is money available.
- The dental plan pays for covered care up to a yearly maximum.
- There are age and frequency limits for certain services.
Plan funding options
- Choose a self-funded or fully insured funding arrangement.
- Under the self-funded option, plan sponsors can allow the fund to help pay for dental expenses not typically covered, including certain services that have age and frequency limits.
- Under the fully insured option, plan sponsors pay a premium that covers the fund and plan benefits. We assume the risk for both.
*In Texas, the Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN).
Dental insurance plans are offered, underwritten and/or administered 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 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 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: GR-9/GR-9N, GR-23 and/or GR-29/GR-29N.
