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Aetna Dental has over 50 years of experience offering dental benefits. With Aetna Dental Direct, you’ll get the coverage you need to keep your teeth healthy. The plan offers preventive treatment at 100% with no out of pocket cost. You can choose from one of the more than 330,000 dentist locations in the Aetna Dental PPO network. Caring for your teeth should never feel out of reach with Aetna Dental Direct.
Benefit | In-network | Out-of-network |
Individual Annual Deductible |
$50 Per Person | $50 Per Person |
Family Annual Deductible |
$150 Per Family | $150 Per Family |
Annual Benefit Maximum | $1,250 Per Person | $1,000 Per Person |
Aetna Dental Direct Preferred PPO | ||
Here is a sample of covered services | In-Network You Pay |
Out-of -Network You Pay |
Preventive services - Waiting period*: None | ||
Preventive oral examinations | No Cost | 20% |
Cleanings | No Cost | 20% |
Full mouth series images | No Cost | 20% |
Sealants (permanent molars only) | No Cost | 20% |
Basic services - Waiting period*: 6 months | ||
Resin filling (1 surface) | 20% | 40% |
Periodontal maintenance cleanings | 20% | 40% |
Extraction (uncomplicated) | 20% | 40% |
Major services - Waiting period*: 12 months | ||
Oral Surgery | 50% | 60% |
Crowns | 50% | 60% |
Root canal therapy | 50% | 60% |
Dentures | 50% | 60% |
Orthodontics | not covered | |
Deductible (calendar year)** | $50 (Individual) | $150 (Family) |
Annual maximum benefit** | $1,250 | $1,000 |
*In Pennsylvania, the "waiting period" is called an "elimination period." | ||
**Deductible and Annual Maximum cross-apply between In-Network and Out-of-Network. Deductible applies to Basic & Major services only. | ||
This is the total amount per person your plan will pay toward the cost of dental care each year.
See dentists both in and out of our network. With our dental insurance plans for individuals, you can get services from either a participating or nonparticipating dentist. Participating dentists have agreed to provide services at a negotiated rate for covered services. You also have the flexibility to visit a licensed dentist who does not participate in our network. However, if you do this, you won’t benefit from negotiated rates.
Dental insurance plans are underwritten by Aetna Life Insurance Company.
This is only a summary of the plan's exclusions and limitations. See the insurance policy for details.
Charges for services or supplies
Aetna Dental Direct PPO Plans are Subject to the Following Rules:
Replacement Rule
The replacement of; addition to; or modification of: existing dentures; crowns; casts or processed restorations; removable denture; fixed bridgework; or other prosthetic services is covered only if specific criteria are met.
Tooth Missing But Not Replaced Rule
Coverage for the first installation of removable dentures; fixed bridgework and other prosthetic services is subject to the requirements that such removable dentures, fixed bridgework and other prosthetic services are:
Alternate Treatment Rule
If more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service. If treatment is being given by a participating dental provider and the covered person asks for a more costly covered service than that for which coverage is approved, the specific copayment for such service will consist of: