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.
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AETNA RETIREE DPO = AETNA RETIREE DMO
Easy-to-use nationwide coverage to fit your budget
The Aetna Retiree DPO is affordable with a lower monthly premium. Aetna’s DMO networks are available to retirees nationwide. There are no claim forms to fill out and no deductibles to pay. Each covered family member must select a participating Primary Care Dentist (PCD) to coordinate all dental care. The DPO\DMO is a in network dental plan only.
Retiree Dental Plan Organization (DPO) Tier 1:
In-networkAnnual Deductible:
NoneCopayments: Diagnostic and preventive benefits only Maximum Annual Benefit/ Individual: None Tier 2:
In-networkAnnual Deductible:
NoneCopayments: Diagnostic and preventive benefits only Maximum Annual Benefit/ Individual: None Tier 3:
In-networkAnnual Deductible:
NoneCopayments: Diagnostic, preventive, restorative, endodontics, periodontics, prosthodontics (removable), prosthodontics (fixed), oral and maxillofacial surgery, and miscellaneous services Maximum Annual Benefit/ Individual: None Step 1: Understand your benefit tier.
- Tier 3 — If you had dental coverage
- Were you covered by another group dental plan for at least 12 months within 60 days before you signed up for the Retiree DPO Plan? If the answer is yes, you’ll be placed in Tier 3, the highest benefit tier.
- Tier 1 — If you did not have dental coverage
- You were not covered by a group dental plan for at least 12 months within 60 days before you signed up for the Retiree DPO Plan. Then you will be place in Tier 1, the lowest benefit. After a year in Tier 1 then you will be placed in Tier 2. Then after the year in Tier 2 you will be moved to Tier 3 the highest benefit.
Step 2: Choose a primary care dentist (PCD) from the nationwide Aetna network.
- Your dental care begins with your PCD. He or she will help you learn about your dental health and how to manage it. Click here to find a dentist now!
- Choosing a dentist is a personal decision. That’s why each family member has his or her own PCD.
- You can change your PCD as often as once a month. Just call Member Services at the number on your Aetna member ID card by the 15th of the month to make your change effective by the first day of the following month.**
Step 3: Pay your share of the cost.
- 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.
*In Illinois, the Dental DMO plan provides limited out-of-network benefits. However, in order to receive maximum benefits, members must select and have care coordinated by their PCD. In Illinois, the Dental DMO plan is not an HMO.
**Your PCD keeps a list of eligible patients that is updated monthly. As long as you contact Member Services by the 15th of the month, your name will appear on this list 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 Retiree Dental Guidebook
- Tier 3 — If you had dental coverage
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AETNA RETIREE DEP = AETNA RETIREE DENTAL PPO
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.
What types of benefits are covered under the DEP plan?
- Download the SHBP\SEHBP Employee Dental Plans Fact Sheet
How the Aetna Retiree DEP Plan works:
Step 1: Understand your benefit tier.
- Tier 3 — If you had dental coverage
- Were you covered by another group dental plan for at least 12 months within 60 days before you signed up for the Retiree Dental Expense Plan? If the answer is yes, you’ll be placed in Tier 3, the highest benefit tier.
- Tier 1 — If you did not have dental coverage
- You were not covered by a group dental plan for at least 12 months within 60 days before you signed up for the Retiree Dental Expense Plan. Then you will be place in Tier 1, the lowest benefit. After a year in Tier 1 then you will be placed in Tier 2. Then after the year in Tier 2 you will be moved to Tier 3 the highest benefit.
Step 2:Decide if you want to go in-network or out-of-network for your care.
- You have the freedom to choose any dentist — in or out of the Aetna network. But, with so many dentists and specialists in the network, chances are your doctor is one of them. You can find out right now! Click here to locate a dentist in the Aetna network.
Step 3: Pay your share of the cost.
- When seeing any dentist, you’ll need to pay a portion of the cost.
- 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 Retiree Dental Expense Plan has a modest deductible for in and out-of-network services.
Did you know?
- Aetna has been in business for over 160 years and is committed to ensuring members like you have access to quality health care.
- We have thousands of providers in New Jersey and nationwide.
- Aetna has over 1.0 million dental members in New Jersey.
Dental benefits online and on the go
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.
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.
Some quick links for you: