Dental Benefits

Good dental health is important to your overall well-being. At the same time, we all need different levels of dental treatment. It is for this reason that Stevens offers two dental plans through Aetna. These plans offer a wide range of dental benefits, from routine preventive and basic care to major services and orthodontia. The PPO dental plan allows you to use any dental provider, however you will receive greater benefits (less out-of-pocket costs) when a participating dentist performs covered dental services. The DMO plan requires that you visit participating DMO providers in order to be covered. Dental benefits are provided to eligible dependents up to age 26.

PPO PLAN

Through this PPO plan, you have the freedom to visit any dentist of your choice; however, if you choose to use a provider that is not a part of the Aetna network you will likely pay more for covered services. You may also be “balance billed” for any amounts between Aetna’s payment and what the dentist charges for services.

DMO PLAN

The Aetna DMO Plan provides benefits when a participating dentist performs covered dental services. Members are required to select a Primary Care Dentist (PCD) from the Aetna network of participating dentists. This plan provides coverage for Preventive/ Diagnostic Services, Basic Services, Major Services and Orthodontia based on Aetna’s contracted rates for participating DMO network dentists. However, this plan does not include coverage for care and services obtained outside of the Aetna network.

DENTAL HIGHLIGHTS

PPO PLAN

PPO PLAN

DMO PLAN

 

PARTICIPATING

NON-PARTICIPATING

PARTICIPATING

Annual Deductible

 

Individual

 

Family

 

$50

 

$150

 

$50

 

$150

No Deductible

$5 Office visit Copay

Annual Maximum Benefit

$1,500

$1,100

No Annual Maximum

Preventative  Services

 

 

100%

100%

no charge

Bacic Services

80%

80%

Copay apply

(refer to the Aetna DMO Benefits Summary for applicable copays)

Orhodontia

Not Covered

Not Covered

$30 Exam copay

$1,845 Treatment copay

Finding a Provider

To find a participating provider near you, please call Aetna at the phone number at the bottom of this page or visit www.aetna.com.

Contact information
www.aetna.com | 877-238-6200