Page 15 - Adreima Enrollment Guide
P. 15
Adreima
To Find a Participating
Dental Provider
1 . Visit www .aetna .com
There will be no changes to the dental coverage through Aetna in 2 . Scroll down until you see the box
2016. You have two plans to choose from: the base plan and buy-up that says “Find a Doctor”
plan. Highlights for both plans are shown below. Coverage for the 3 . Sign in or click “Find Doctors and
base plan is not as rich as the buy-up plan, but you will pay less in Hospitals in our Plans”
monthly contributions. If you use your dental plan often, it may be
better to pay more per paycheck for a richer beneit under the buy-up 4 . Click “Through an Employer or
Organization”
plan. The buy-up plan also offers orthodontia for children up to age
19. 5 . Follow the website by using the
search bar or the list of Healthcare
If you see a participating provider, preventive care is covered at 100 Professionals
percent. An annual deductible will apply for basic and major services.
The coinsurance amounts listed below relect the portion the plan
will pay toward applicable services.
Base Plan Buy-up Plan
Out-of- Out-of-
PPO Network PPO Network
Calendar Year Deductible
Individual $50 $75 $25 $75
Family $150 $225 $75 $225
Calendar Year Maximum
$1,500 $2,000 $1,500
Coinsurance
Preventive 100% 80% 100% 100%
Basic 80% 70% 100% 80%
Major 50% 50% 60% 50%
Orthodontia
Coinsurance 50%
Lifetime $1,500
Maximum Not Covered
Beneit Children
applies to
* Preventive care services have a deductible for out-of-network services only .
15
To Find a Participating
Dental Provider
1 . Visit www .aetna .com
There will be no changes to the dental coverage through Aetna in 2 . Scroll down until you see the box
2016. You have two plans to choose from: the base plan and buy-up that says “Find a Doctor”
plan. Highlights for both plans are shown below. Coverage for the 3 . Sign in or click “Find Doctors and
base plan is not as rich as the buy-up plan, but you will pay less in Hospitals in our Plans”
monthly contributions. If you use your dental plan often, it may be
better to pay more per paycheck for a richer beneit under the buy-up 4 . Click “Through an Employer or
Organization”
plan. The buy-up plan also offers orthodontia for children up to age
19. 5 . Follow the website by using the
search bar or the list of Healthcare
If you see a participating provider, preventive care is covered at 100 Professionals
percent. An annual deductible will apply for basic and major services.
The coinsurance amounts listed below relect the portion the plan
will pay toward applicable services.
Base Plan Buy-up Plan
Out-of- Out-of-
PPO Network PPO Network
Calendar Year Deductible
Individual $50 $75 $25 $75
Family $150 $225 $75 $225
Calendar Year Maximum
$1,500 $2,000 $1,500
Coinsurance
Preventive 100% 80% 100% 100%
Basic 80% 70% 100% 80%
Major 50% 50% 60% 50%
Orthodontia
Coinsurance 50%
Lifetime $1,500
Maximum Not Covered
Beneit Children
applies to
* Preventive care services have a deductible for out-of-network services only .
15
