Aetna Dental Copay

Dental Insurance Aetna
Aetna Dental Copay
Aetna Dental Copays
Aetna Dental Ppo Copay
Aetna Copay Plans
How Much Does Aetna Cover For Dental
Aetna Copay Information

Video Transcript

An example of how it works: Courtney, 43, is a single lawyer who just bought her first home, a condo in Midtown Atlanta. She loves that her building has a gym and pool because she likes to stay in shape. When she felt a lump in her breast during a self-exam, she immediately had it checked out. Built-in dental, too Use our Basic Dental Network. Call 1-800-537-9384 to select a dentist OR to switch to our larger PPO network at no additional cost. It's your choice! Basic - Pay a $5 copay for cleanings, fillings and X-rays when you visit your primary care dentist (PCD). Aetna Vital Dental Savings SM Reduce the costs of dental care and choose your own dentist from one of the nation’s largest dental savings networks. Save 15% to 50%. on dental services, everything from preventative care (x-rays, cleanings, checkups, sealants) to.

Intro:

Welcome! Thanks for joining us to learn more about Aetna Dental^® plans. If you're a current employee, a retiree or a new employee with the State of New Jersey, you're in the right place.

Aetna^®, along with the State Health Benefits Program and the School Employees’ Health Benefits Program, are offering two active member dental plans and two retiree dental plans.

Even if you like the plan you’re in, it’s a good idea to review your plan selections every year. Aetna offers cost-effective, easy-to-understand nationwide dental programs for you to choose from.

Let’s take a look…

The Aetna Dental Expense Plan and Retiree Dental Expense Plan are offered to members by Aetna. These plans are great for members who like the freedom to go in and out of the Aetna network. With these plans, members can see any licensed dentist – no referral required!

The Dental Plan Organization and Retiree Dental Plan Organization are great nationwide plans for members who like to budget their costs – with a lower monthly premium compared to the Dental Expense Plan. These plans are in-network-only dental plans, and members select a primary care dentist when enrolling.

Today we will cover the benefits available to active employees under both the Aetna Dental Expense Plan and the Dental Plan Organization. Let's take a closer look at the plan details.

The Aetna Dental Expense Plan, or DEP, consists of our Preferred Provider Organization, also referred to as the PPO network of providers, with both in- and out-of-network coverage.

The benefits of the in-network Aetna Dental Expense Plan are:

An annual deductible of $50 for individuals and $100 for families
Preventive services, such as diagnostic and preventive care, covered at 100%
Basic services, such as routine fillings and extractions, paid at 80%
Major services, such as crowns, paid at 65%
An annual plan maximum of $3,000 for in-network services

And for out-of-network benefits, the following amounts apply:

An annual deductible of $75 for individuals and $150 for families
Preventive services, such as diagnostic and preventive care, covered at 90%
Basic services, such as routine filings and extractions, paid at 70%
Major services, such as crowns, paid at 55%
An annual plan maximum of $2,000 for out-of-network services

The plan maximum combined for in- and out-of-network services, is $3,000, excluding orthodontics.

Orthodontics are covered only for dependents who start treatment before age 19. In network has a $1,000 lifetime maximum, and out of network has a $750 lifetime maximum.

Remember to stay in network whenever possible.

Now, let’s move on to the second plan, the Dental Plan Organization.

The second plan Aetna offers is the Dental Plan Organization – or DPO – which uses Aetna’s in-network Dental Maintenance Organization, also referred to as DMO. This plan requires members to select a primary dentist and obtain referrals to see a dental specialist.

The benefits of the Dental Plan Organization include:

No annual deductible
Preventive services, such as diagnostic and preventive care, covered at 100%
A copay for basic services, such as routine fillings and extractions, and major services, such as crowns
No annual plan maximum

Copays will vary by type of service.

Dental Plan Organization orthodontics are covered for all members. For members under age 18, the lifetime maximum is $1,000 or 50% billed – whichever is less. For members over age 18, the lifetime maximum is $1,750 or 50% billed – whichever is less.

In summary, this plan is more cost effective, you’ll pay less out of pocket for services, plus it carries a lower premium. Check to see if your provider participates in the Dental Plan Organization, and then be sure to choose a primary care dentist when you enroll!

Now let’s take a moment to show you how to explore the Employee Dental Plan website.

The Aetna State of New Jersey website at AetnaStateNJ.com is the resource for Aetna Dental plan options for State of New Jersey employees, their families and retirees.

To review Aetna Dental plan options for current employees or retirees, select Dental in the menu bar, then Employee Dental Plans or Retiree Dental Plans.

You’ll have access to detailed information on both plans by selecting the plus sign next to each plan name. Not sure which plan is right for you? You can view the Dental Benefits at a Glance PDF, available for download.

Dental Insurance Aetna

If you need to find a primary care dentist, please choose Find a Doctor in the top menu bar. This will open a new page, where you can Continue as a guest and enter your ZIP code.

Under Dental Plans, select Dental Plan Organization for the in-network plans or Dental Expense Plan for the in- and out-of-network plans.

Next, select Dental Care, then Dentists (Primary Care). A list of participating providers will be shown.

If you’re selecting the Dental Plan Organization, you’ll need to make note of the Primary Care ID number on your dental application.

As an Aetna member, you can also receive discounts and savings on certain benefits. To learn more, select Tools & Resources in the menu bar on AetnaStateNJ.com, then select Discount Programs to view available programs and their offerings.

Once you’re a member, you can log in to the Aetna member website to view claims, print an ID card and access all your benefits information.

Closing:

Thanks for sharing time with us to review Aetna Dental plan options. To enroll in a plan, contact your human resources representative. For additional information, please visit the Aetna State of New Jersey website, AetnaStateNJ.com, or call our customer service team at 1-877-StateNJ – that’s 1-877-782-8365 – and see how Aetna can make you and your family smile!

Disclaimer:

Plans are administered by Aetna Life Insurance Company (Aetna). Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Refer to Aetna.com for more information about Aetna® plans.

Giving You a Reason to Smile

Aetna offers easy to understand dental benefit plans. Even if you like the plan you’re in, it’s a good idea to review your plan selections every year. We offer cost effective, nationwide dental programs for you to choose from. Take a look today to see how Aetna can make you and your family smile.

The Aetna DPO is affordable with a lower monthly premium compared to the Dental Expense Plan! Aetna’s DMO networks are available to employees nationwide. DMO is a in network dental plan only.

Take two easy steps to start your dental care

Step 1: Pick a PCD

Aetna Dental Copay

Your DMO benefits and insurance plan begins with your primary care dentist (PCD). Click here to find a dentist now!
See your PCD for regular exams. Your PCD can refer you to other dentists if you need specialty care.
Obtain the appropriate preventive care per the benefits schedule at no charge to you.
Each covered family member can pick a different PCD. You can change your PCD as often as once a month. Contact Member Services by the 15th of the month to make your change effective by the first day of the following month.*

Step 2: Visit your PCD

Pay your copay. A copay is the fixed dollar amount you pay when receiving care. It is based on the type of service you have performed**.
Pay your copay for services other than diagnostic or preventive.
There is no deductible — and there are no annual dollar limits.
You will not need to complete any claim forms.

Step 3: Pay your share of the cost.

Preventive services are covered at 100%.
Your PCD will help you decide if you need care from another dentist. If so, he or she will give you a referral to another Aetna network dentist.
To make it easier, when you visit an orthodontist who participates in the Aetna network, you won’t need a referral.

*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 appear on this printed monthly roster. Once you are a member, you can call Member Services if your doctor needs to verify your eligibility.

**A full list of copayments is located in the Employee Dental Plans Member Guidebook

Freedom to choose any dentist

Aetna Dental Copays

A plan exclusively offered to you by Aetna. This nationwide plan is great for members who like the freedom to go in and out-of the Aetna network.

Ah, Freedom! See any licensed dentist you choose!

No referrals required
No need to choose a primary care dentist
Affordable coverage for cleanings, X-ray, restorative work and more
Choose from a nationwide network of participating dentists

It’s your choice whenever you need dental care

Aetna Dental Ppo Copay

Step 1: Decide if you want to go in-network or out-of-network for your care

Aetna Copay Plans

You have the freedom to choose any doctor — in or out of the Aetna network. But, with so many primary care doctors and specialists in New Jersey’s Aetna network, chances are your doctor is one of them. You can find out right now! Visit your custom Provider Search to find a dentist by name or by zipcode.

Step 2: Visit your dentist

Show your Aetna member ID card.
Preventive services are covered at 100% in-network. Plus, there’s no deductible for preventive services.
You can see a specialist without a referral. Doctors in Aetna’s network will submit claims for you. If you go outside the network, you can get claim forms from our Aetna Member website.

Step 3: Pay your share of the cost.

Dental benefits online and on the go

How Much Does Aetna Cover For Dental

Your secure, personalized, member website
Make the most of your dental insurance plan. You can use your secure Aetna member website to manage your dental care and dental care costs. See details about your plan, get an ID card and review your claims. Compare costs for dental care providers. And so much more. Click here to register today!

You’re mobile — so are we.

Aetna Copay Information

Use your smartphone to log in and manage your dental care. Learn more, visit us at www.aetna.com/mobile.

Call 1-877-STATENJ (1-877-782-8365) and talk to someone from Dental Member Services who knows all the details about the available Aetna plans.