New Jersey School Employees’ Health Benefits Program

DPO (Dental Plan Organization)

Easy-to-use coverage to fit your budget

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.

Take two easy steps to start your dental care

Step 1: Pick a PCD

• 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.

• Show your Aetna member ID card when you go.
• 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 Handbook

Do you know what plan you want?

DEP (Dental Expense Plan)

Freedom to choose any dentist

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

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

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 DocFind® site to search by a specific name or by zip code.

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 Navigator® website.

Step 3: Pay your share of the cost.

• When seeing a dentist, you’ll need to pay a portion of the cost, or what is called coinsurance.
• You’ll often pay less if you stay in the Aetna network. We agree on rates with providers in our network. But, we cannot control the amount an out-of-network provider may charge.
• The Dental Expense Plan has a modest deductible for in- and out-of-network services.

Do you know what plan you want?