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BENEFITS

Dental Insurance

Meritain Health (Aetna) | PPO Dental Plan
With the Preferred Provider Organization (PPO) dental plan, you may visit a PPO dentist within the “Aetna Dental Access” network,
and benefit from the negotiated rate or visit a non‐network dentist. When you utilize a PPO dentist, your out-of-pocket expenses
will be less. You may also obtain services using a non-network dentist; however, you will be responsible for the difference between
the covered amount and the actual charges and you may be responsible for filing claims.

Meritain Health (Aetna)
Plan Name PPO Plan
Network Name Aetna Dental Access Non-Network
Dental Benefits

Calendar Year Maximum $1,500
Finding a
Deductible (Calendar Year) Dental Provider
- Individual $25 Online: Go to
- Family $75
www.aetna.com/docfind/
Preventive No Charge No Charge (UCR) custom/mymeritain/
Exams, X-Rays, Cleanings Telephone: Call Meritain at
(800) 925-2272
Basic Services Deductible, 10% Deductible, 10% (UCR)
Fillings, Oral Surgery,
Endodontics, Periodontics

Major Services (Waiting period of 12 Deductible, 40% Deductible, 40% (UCR)
consecutive months)
Crowns, Prosthetics
Orthodontia Benefits
Covered Members Children (up to age 19)

Coinsurance Deductible, 50%
Lifetime Benefit Maximum $1,000

Tips For Using Your Dental Benefits


Use contracted network providers when possible.
Contracted network providers have rate agreements with insurance companies for services rendered. If you use a non-
network provider, your out-of-pocket expenses will be higher and you may be subject to balance billing.

Ask for a predetermination of benefits.

We strongly recommend you ask your dentist for a predetermination if total charges are expected to exceed $300.
Predetermination enables you and your dentist to know in advance what the payment will be for any service that may be in
question.

Have dental checkups regularly.

Routine dental visits not only preserve your smile, but they can provide an opportunity for the early detection of serious
diseases such as diabetes.

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