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Network-option dental insurance plans

Flexibility and no referrals

 


Enjoy flexible dental health plan options that work for your business. Offer a Preferred Provider Organization (PPO)* dental insurance plan.

Dental insurance plan features

  • Employees can visit any licensed dentist without a referral.
  • Coverage for preventive, basic and major services.**
  • We have contracted rates with network dentists that are often much lower than their regular fees. That means your employees may save money by staying in our network. 
  • To learn more, view the PPO video.

Dental plan options

  • Choice of deductibles, coinsurance levels, maximums and benefits levels.
  • Choose from self-funded or fully insured options. 
  • These plans may fit your needs.***

The most common structures behind our plans are:

  • 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 nonparticipating dentists will be reimbursed based on the standard negotiated fee only, and may be balance billed by the dentist.

Available as a standalone plan, a dual option to our DMO plan, or as part of our Freedom-of-Choice plan.

Cost savings

  • Offer a PPO plan to employees who pay 50% or more of the premium.
  • Ask about our low cost PPO plan, Aetna Dental Preventive CareSM 
  • Ask about our PPO II network****. It’s a vendor-based network that adds thousands more PPO dental practice locations nationwide. That can mean greater access to dental services at contracted rates. Better for your employees’ pockets and yours.

 

PPO dental plans at a glimpse 

PPO dental plansNetworksPlan options**FundingPCD requiredPlan maximum
PPO Members can visit any licensed dentist. They may pay less if they choose a dentist from our large PPO network PPO, Aetna Dental PPO II (vendor-based)***Deductible and/or coinsuranceFully or self-insuredNoYes
Aetna Dental Care RewardSM Rewards members the next plan year for visiting a dentist for preventive care during the current plan year PPO, Aetna Dental PPO II (vendor-based)***Deductible and/or coinsuranceFully or self-insuredNoYes
Aetna Dental Preventive CareSM Members get preventive care and some diagnostic services covered at 100% in one cost-savings plan when they visit a network dentist.PPO, Aetna Dental PPO II (vendor-based)***

No deductible or copay for preventive care and diagnostic services

Coinsurance applies

Fully or self-insuredNoYes
Aetna DentalFund® PPO Combines base dental coverage with a fund to help your employees pay for their dental expenses. The fund can offset their eligible out-of-pocket costs, up to the fund balance. Leftover monies roll over to the next plan year. Contributions are tax-deductible. PPO, Aetna Dental PPO II (vendor-based)****Deductible and/or coinsuranceFully or self-insuredNoYes
Two plans in oneNetworksPlan optionsFundingPCP requiredAnnual maximum

Freedom-of-Choice One premium, two plans. Employees can switch each month between a DMO* and either a dental PPO*** or indemnity dental insurance plan option that you choose

Dual Choice Two premiums/rates, two plans. Employees can select either an Aetna DMO or dental PPO or Indemnity plan at enrollment (no monthly switch)

DMO* and PPO, Aetna Dental PPO II (vendor based)†

No network for indemnity

DMO*:
Fixed copay, coinsurance, no deductible

PPO and Indemnity:
Deductible and/or coinsurance

DMO*:
Fully insured

PPO and Indemnity:
Fully or self- funded

DMO*:
Yes

PPO or Indemnity:
No

DMO*:
No

PPO or Indemnity:
Yes

FAQs

Get the answers to our most frequently asked PPO* member questions.

*In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN)

**Dental benefits and dental insurance plans contain exclusions and limitations  (PDF). Deductible, coinsurance and annual plan maximums may apply. Please note customer may chose to apply a deductible andor lower coinsurances.

***Plan options may vary by state.

****Providers may participate with Aetna through an agreement Aetna has with a vendor. The provider may not be directly contracted with Aetna, and, consequently, not credentialed by Aetna. Providers available through these vendors are only subject to the credentialing requirements, if any, of the vendor.

†Included with fully insured plans. Optional with self-funded plans. PPO II providers participate through an agreement that Aetna has with a vendor. The provider may not be directly contracted with Aetna, and, consequently, not credentialed by Aetna. Providers available through these vendors are only subject to the credentialing requirements, if any, of the vendor.

††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 participation primary care dentist.  Illinois DMO is not an HMO.

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. 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 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 includeGR-9/GR-9N, GR-23 and/or GR-29/GR-29N.

Legal Notices

Dental benefits and insurance plans contain exclusions and limitations  (PDF).

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