Dental benefits are provided through the Aetna Dental Select PPO plan. The plan covers a comprehensive range of dental treatments, including 100% of preventive care,* 80% of in-network basic-level dental services and 50% of in-network major and orthodontic care services.
* Out-of-network services are subject to reasonable and customary charges.
Summary of Benefits
|Plan Feature||Aetna Dental Select PPO
|Aetna Dental Select PPO
(August 1–July 31)
|Preventive Care||Plan pays 100%, no deductible||Plan pays 100%, no deductible|
|Basic Care||Plan pays 80% after deductible||Plan pays 70% after deductible|
|Major Care||Plan pays 50% after deductible||Plan pays 40% after deductible|
|Orthodontic Care||Plan pays 50%, no deductible||Plan pays 40%, no deductible|
|Orthodontic Lifetime Maximum||$1,500||$1,000|
** Out-of-network plan payments are based on the 90th percentile of prevailing charges for the geographic area.
Aetna does not issue dental ID cards. You can print an ID card by logging onto the Aetna website. Your provider will verify your eligibility directly with Aetna.
|Coverage Level||Per-Paycheck Cost|
|Employee + Spouse/Domestic Partner||$23.35|
|Employee + Children||$18.68|
|Employee + Family||$28.02|