Page 10 - Future Steps
P. 10
In this dental plan, you have
the option to receive care from
an in-network or an out-of-
network dentist. This benefit Dental Coverage
the same regardless of network
status, however, you will Dental Benefit Summary
receive the deepest discount
and pay less out of your pocket Aetna
when you receive care from Passive PPO
an in-network dentist. You can
look to see if your dentist is Network: PPOII
in-network or locate an Aetna In-Network/Out-of-Network
dentist at www.aetna.com. Individual $50
Be sure to search for dentists
in the PPO II Network. Family $150
Calendar Year Maximum (per Person) $2,000
Coinsurance (Plan Pays)
Preventive 100% no deductible
Basic 80% after deductible
Major 50% after deductible
Orthodontia
Coinsurance 60% no deductible
Lifetime Maximum $1,500
Benefit Applies to Children only
(appliance must be placed prior to age 20)
Diagnostic/Preventive Services
Includes Cleanings, Fluoride, Sealants, X-Rays 100% no deductible
Basic Services
Includes Oral Surgery and Fillings 80% after deductible
Major Services
Includes Crowns, Bridges, Full and Partial 50% after deductible
Dentures
Notes: this is a synopsis of coverage only; the beneits summary contains exclusions and limitations which are
not shown here. Please refer to the beneits summary for the full scope of coverage.
The dental plan will remain with Aetna for 2017. There will be no changes to the
beneit. We encourage you to stay up-to-date with your dental cleanings. Regular
dental exams can help you and your dentist detect problems in the early stages, not
to mention treatment is simpler and costs are lower. Keeping your teeth and gums
clean and healthy will help prevent most tooth decay and periodontal disease, and is
an important part of maintaining your overall health.
No ID Card Necessary
Using your dental beneits has never been easier. Simply let your dental provider
know your coverage is through Aetna and ensure they have your correct SSN to
verify your eligibility and beneits. That is it!
10
F+W, A Content + eCommerce Company
the option to receive care from
an in-network or an out-of-
network dentist. This benefit Dental Coverage
the same regardless of network
status, however, you will Dental Benefit Summary
receive the deepest discount
and pay less out of your pocket Aetna
when you receive care from Passive PPO
an in-network dentist. You can
look to see if your dentist is Network: PPOII
in-network or locate an Aetna In-Network/Out-of-Network
dentist at www.aetna.com. Individual $50
Be sure to search for dentists
in the PPO II Network. Family $150
Calendar Year Maximum (per Person) $2,000
Coinsurance (Plan Pays)
Preventive 100% no deductible
Basic 80% after deductible
Major 50% after deductible
Orthodontia
Coinsurance 60% no deductible
Lifetime Maximum $1,500
Benefit Applies to Children only
(appliance must be placed prior to age 20)
Diagnostic/Preventive Services
Includes Cleanings, Fluoride, Sealants, X-Rays 100% no deductible
Basic Services
Includes Oral Surgery and Fillings 80% after deductible
Major Services
Includes Crowns, Bridges, Full and Partial 50% after deductible
Dentures
Notes: this is a synopsis of coverage only; the beneits summary contains exclusions and limitations which are
not shown here. Please refer to the beneits summary for the full scope of coverage.
The dental plan will remain with Aetna for 2017. There will be no changes to the
beneit. We encourage you to stay up-to-date with your dental cleanings. Regular
dental exams can help you and your dentist detect problems in the early stages, not
to mention treatment is simpler and costs are lower. Keeping your teeth and gums
clean and healthy will help prevent most tooth decay and periodontal disease, and is
an important part of maintaining your overall health.
No ID Card Necessary
Using your dental beneits has never been easier. Simply let your dental provider
know your coverage is through Aetna and ensure they have your correct SSN to
verify your eligibility and beneits. That is it!
10
F+W, A Content + eCommerce Company
