Network Option Dental Plans (PPO)
A flexible dental plan with no need for referrals
Preferred Provider Organization (PPO)* dental insurance plans provide flexible dental health plan options.
Plan features
- Members can visit any licensed dentist without a referral.
- The plan provides coverage for preventive, basic and major services.**
- The contracted rates with network dentists are often much lower than their regular fees. This may save members money by staying in our network.
Plan options
- Choice of deductibles, coinsurance levels, maximums and benefits levels.
- Choose from self-funded or fully insured options.
- Options include the Aetna Dental Care RewardSM plan and the Aetna DentalFund® plan.
The most common structures behind our plans
- Passive plan – Deductible and coinsurance amounts are the same for in-network and out-of-network services.
- Active plan – Deductible and coinsurance amounts are different for in-network and out-of-network services.
- PPO Max plan – Members who use non-participating dentists will be reimbursed based on the standard negotiated fee only and may be balance-billed by the dentist.
Cost savings
- Offer a PPO plan to those who pay 50% or more of the premium.
- Ask about our low cost PPO plan, Aetna Dental Preventive CareSM.
- Our PPO II network*** is a vendor-based network that adds thousands more PPO dental practice locations nationwide. That can mean greater access to dental services at contracted rates.
PPO plans at a glance
|
PPO dental plans |
Networks |
Plan options |
Funding |
PCD required |
Plan maximum |
|
PPO |
PPO, Aetna Dental PPO II (vendor-based) |
Deductible and/or coinsurance |
Fully or self-insured |
No |
Yes |
|
Aetna Dental Care Reward |
PPO, Aetna Dental PPO II (vendor-based) |
Deductible and/or coinsurance |
Fully or self-insured |
No |
Yes |
|
Aetna Dental Preventive Care |
PPO, Aetna Dental PPO II (vendor-based) |
No deductible or copay for preventive care and diagnostic services Coinsurance applies |
Fully or self-insured |
No |
Yes |
|
Aetna DentalFund PPO |
PPO, Aetna Dental PPO II (vendor-based) |
Deductible and/or coinsurance |
Fully or self-insured |
No |
Yes |
|
The choice of two plans
|
Networks |
Plan options |
Funding |
PCP required |
Plan maximum |
|
Freedom-of-Choice |
DMO and PPO, Aetna Dental PPO II (vendor based) |
DMO: |
DMO: |
DMO: |
DMO: |
|
Dual Choice |
No network for indemnity |
PPO and indemnity: |
PPO and indemnity: |
PPO or indemnity: |
PPO or indemnity: |
*In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN).
**Plan options may vary by state.
***Included with fully insured plans. Optional with self-funded plans.
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 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.
