What to do
Aetna Dental® coverage through work
When you have an Aetna Dental plan, you know you’re taking the right steps to being healthy. You get a broad choice of providers, wellness discounts, helpful guidance to manage your care, and more.
Enjoy our national network
Choose from thousands of quality dental providers nationwide, including those who offer virtual dentist visits.
Helping you choose the right dental plan for you
Helping you choose the right dental plan for you
All Aetna Dental plans offer a choice of dentists, health discounts and digital tools. Your specific costs and features depend on the plan you choose. Need help comparing plans? Learn about our DMO® dental benefits and insurance plan and PPO dental insurance plan. And be sure to ask your employer which plans are available to you.
How our dental DMO plan works
A primary care dentist (PCD) helps guide your care with this DMO plan*.
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How it works |
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Choose a PCD from our network: This will get you on the dental office’s list of patients.* To find a dentist or office near you, use our provider search tool. |
See your PCD for regular exams and to get referrals if you need specialty care.
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Visit your PCD: If you see someone other than the PCD you chose, you could pay more. |
Check your benefits summary, so you’ll know what to pay. Pay your share of the cost. This may be a copay, which is a set dollar amount. Or it may be coinsurance, which is a percentage of the dentist’s charge. That’s it. No deductible, no claims forms and no yearly dollar limits. |
What to do |
Choose a PCD from our network: This will get you on the dental office’s list of patients.* To find a dentist or office near you, use our provider search tool. |
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How it works |
See your PCD for regular exams and to get referrals if you need specialty care.
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What to do |
Visit your PCD: If you see someone other than the PCD you chose, you could pay more. |
How it works |
Check your benefits summary, so you’ll know what to pay. Pay your share of the cost. This may be a copay, which is a set dollar amount. Or it may be coinsurance, which is a percentage of the dentist’s charge. That’s it. No deductible, no claims forms and no yearly dollar limits. |
How our dental PPO plan works
Get the freedom to care for your smile your way. As a dental PPO member, you can access virtual dentistry options for routine evaluations, second opinions, referrals and prescriptions. Our network of virtual dentistry providers includes Dental.com and TheTeleDentists.
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Your options |
Pick your dentist |
How it works |
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In network: no paperwork, lower costs |
Visit a dentist in the Aetna Dental PPO* network. |
Network dentists offer special rates for covered services. So your share of the cost is usually lower. Network dentists file claims for you. |
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Out-of-network: more choices and flexibility |
Visit any licensed dentist outside the network. |
You may pay more when you get care from dentists who aren’t in the network.* You may have to file your own claims. |
Your options |
In network: no paperwork, lower costs |
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Pick your dentist |
Visit a dentist in the Aetna Dental PPO* network. |
How it works |
Network dentists offer special rates for covered services. So your share of the cost is usually lower. Network dentists file claims for you. |
Your options |
Out-of-network: more choices and flexibility |
Pick your dentist |
Visit any licensed dentist outside the network. |
How it works |
You may pay more when you get care from dentists who aren’t in the network.* You may have to file your own claims. |
Aetna DMO or Aetna PPO? We can help you decide.
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Aetna Dental DMO |
Aetna Dental PPO |
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Primary care dentist: You need to choose a primary dentist (PCD) who’s in our network. |
Primary care dentist: You don’t have to select a primary care dentist. And you have a larger network of dentists to choose from. You save more when you stay in network.
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Premiums: Generally, your premiums are lower. |
Premiums: Generally, your premiums are higher. |
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Deductibles: There are no deductibles or yearly dollar limits. |
Deductibles: There are deductibles and yearly dollar limits. |
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Referrals: A referral is needed for specialists. No referral is needed for orthodontists. |
Referrals: No referral is needed for specialists. |
Aetna Dental DMO |
Primary care dentist: You need to choose a primary dentist (PCD) who’s in our network. |
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Aetna Dental PPO |
Primary care dentist: You don’t have to select a primary care dentist. And you have a larger network of dentists to choose from. You save more when you stay in network.
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Aetna Dental DMO |
Premiums: Generally, your premiums are lower. |
Aetna Dental PPO |
Premiums: Generally, your premiums are higher. |
Aetna Dental DMO |
Deductibles: There are no deductibles or yearly dollar limits. |
Aetna Dental PPO |
Deductibles: There are deductibles and yearly dollar limits. |
Aetna Dental DMO |
Referrals: A referral is needed for specialists. No referral is needed for orthodontists. |
Aetna Dental PPO |
Referrals: No referral is needed for specialists. |
Consider a DMO plan if ...
- Your dentist is in our network. Use our provider search tool to check if your dentist participates in our DMO plan.
- You expect major dental services, and your dentist is in network. The DMO has no lifetime limit for major services.
- The cost is most important. The DMO plan has lower premiums, so you can end up saving money.
Consider a PPO plan if ...
- The ability to visit any dentist is most important. You can see any licensed dentist with this plan, so the network is generally larger than the DMO network.
- You're looking to see a specialist without having to get a referral. You don’t need a referral to see a specialist with this plan.
Healthy mouth, healthy body
Routine dental care can help you have stronger teeth, healthier gums and a brighter smile. Studies show that a healthy mouth helps you avoid health problems in the body, too.
Mouth/body connection
Understand the link between oral health and overall health.
Member perks and savings
Wellness discounts that extend the value of your plan
Aetna Dental plans come with special perks and discounts, including exclusive offers from CVS Health®. There are no claims, referrals or limits on how much you can save.
At-home products
Get a discount on blood pressure monitors, pedometers, activity trackers, pain relief devices and other Omron® products.
Fitness and coaching
Save on gym memberships, health coaching, fitness gear, wearable fitness devices, group fitness on demand and more.
Weight management
Get savings on weight-loss programs and meal plans, and enjoy one-on-one help, personalized menus, online tools and chat rooms.
Natural products and services
Pay less* for acupuncture,* chiropractic visits, therapeutic massage and nutrition services. You also save on products like wearable fitness devices and fitness kits.
Eyewear and exams
Save on popular designer frames* and vision items that don’t need a prescription.* You can visit national chains and thousands of doctors in private practice.
Hearing aids and exams
Enjoy discounts on hearing aids, exams and hearing aid batteries mailed to your home. Choose from leading manufacturers and get free follow-up service for one year.
Oral health care
Get discounts on oral health care products like Z Sonic™ toothbrushes, replacement brush heads and various oral health care kits.
Digital plan tools
Helpful guidance to make care easier
You also get digital tools to help you manage your plan, save money and make smart decisions about your care. You can:
- Find network providers, including those offering virtual visits
- Get information about what’s covered
- Check and pay claims
- Pull up your ID card whenever you need it
Once you’re a member, you have two ways to manage your plan.
For dental consumers in New York
An online cost estimate of services is available to you.
For DMO plan claim
In Illinois, the Aetna Dental DMO plan provides limited out-of-network benefits. To receive maximum benefits, members must select and have care coordinated by their PCD. In Illinois, the Aetna Dental DMO plan is not a health maintenance organization (HMO). In Virginia, the DMO plan is known as the Aetna Dental Network Only plan (DNO). DNO in Virginia is not an HMO. To receive maximum benefits, members must choose a participating PCD to coordinate their care with network providers.
For PCD list of patients
Your PCD keeps a list of eligible patients that is updated monthly. Your name will appear on this list when it is updated the month after your selection. Some dentists will only treat patients whose names are on this printed monthly roster. Once you're a member, call Member Services if your dentist needs to confirm your eligibility.
For Aetna Dental PPO claim
In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN).
For out-of-network claim
Out-of-network benefits are paid based on recognized charge levels, as determined by Aetna and specified in your plan documents.
For pay less claim
Through the ChooseHealthy program, which is provided by ChooseHealthy, Inc., a subsidiary of American Specialty Health Incorporated (ASH). ChooseHealthy is a federally registered trademark of ASH and used with permission herein.
For acupuncture claim
Acupuncture is an essential health benefit. The discount for this service may duplicate benefits if you’re enrolled in a full-service plan.
For designer frames claim
Certain brands have a no-discount policy.
For eyewear prescriptions claim
Pediatric dental essential health benefits include frames for glasses for pediatric patients. The discount for frames may duplicate benefits if you’re enrolled in a vision plan that covers your dependent children.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
This material is for information only. Dental information programs provide general dental information and are not a substitute for diagnosis or treatment by a dentist or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change.
Dental benefits and dental insurance plans contain exclusions and limitations.