How dental coverage works

​Dental Plan coverage includes 

  • preventive and diagnostic care, such as routine checkups and cleanings;
  • basic services, such as fillings;
  • major services, such as prosthodontics and crowns; and
  • orthodontic treatment for eligible children (provided the member has been enrolled in dental coverage through the Board for one year, and children are under age 20 when treatment begins).

If your employer offers dental coverage, you are eligible for at least one of the following, depending on where you live (determined by home address ZIP code). All preventive and diagnostic services, such as routine checkups, cleanings, and bitewing X-rays, are 100 percent covered, regardless of whether coverage is through the DMO, PPO, or Passive PPO option.

  • DMO (dental maintenance organization): The DMO (a dental HMO) offers benefits for services provided by a primary care dentist selected from the network of participating DMO dentists. If you select DMO dental coverage, you and each covered family member must choose a primary care dentist and provide the appropriate office number as part of the enrollment process.
  • PPO (preferred provider organization): The PPO gives members the option to receive care from a dentist who participates in Aetna’s dental network (a network provider) or one who does not (an out-of-network provider). Aetna network providers have agreed to charge lower, negotiated fees, which results in lower out-of-pocket costs for members. In addition, there are generally no claim forms to file when using network providers.
  • Passive PPO (offered in areas without reasonable access to PPO providers): The Passive PPO gives members the option to receive care from a dentist who participates in Aetna’s dental network (a network provider) or one who does not (an out-of-network provider) at the same benefit level. When care is provided by a network provider, there are no claim forms to file.

Visit the Aetna website to locate network dentists, or call Aetna member services at 877-238-6200.