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Pro Network Dental Plans

PPO NETWORK DENTAL PLANS

Choose a Denali PPO Network Dental plan and save on out-of-pocket costs when visiting an in-network provider. Pay less for in-network services – the percentage you pay is based on a discounted rate.

Denali Dental PPO Coverage Chart

This Dental Insurance Plan helps you cover the costs of dental care. Covered dental services include exams, cleanings, fillings and extractions, as well as crowns, bridges and dentures. This policy pays you for covered dental expenses based upon the reimbursement schedule of the PPO network fees for those covered expenses after the $100 lifetime deductible has been satisfied.

These percentages are: 100% for Preventive Services, 40% for Diagnostic Services, 20% for Basic & Major and 10% for Child Orthodontia Services in the 1st year. In the 2nd year of coverage, Diagnostic Services increase to 80%, Basic & Major Services increase to 50% and Child Orthodontia increases to 25%. In the 3rd year Diagnostic Services increase to 90%, Basic and Major increase to 60% and Child Orthodontia increases to 50%.

PREVENTIVE SERVICES

  • Two exams per year
  • Three cleanings per calendar year

DIAGNOSTIC SERVICES

  • One series of bitewing x-rays per year
  • Flouride treatments limited to dependents under age 19

BASIC & MAJOR SERVICES

  • Simple extractions
  • One diagnostic x-ray, full or panoramic in any 3 year period
  • Oral surgery
  • Endodontic treatment
  • Periodontic services
  • Restoration services; inlays, onlays and crowns
  • Prosthetic services; bridges and dentures
  • Veneers
  • Endosteal implants
  • Basic fillings

ORTHODONTIA SERVICES

  • Orthodontic treatment for dependent children under age 19. (Not available in Georgia)

BENEFITS

Calendar Year Maximum - $1,500, $2,500 or $3,500 per insured
Lifetime Deductible - 
$100 per person/
$300 per family

REASONABLE AND CUSTOMARY

Dental expenses are paid based on a percentage of Reasonable and Customary (R&C) fees. This means the most common charge for similar professional services, drugs, procedures, devices, supplies or treatment within the Geographic Area in which the charge is incurred. The most common charge means the lesser of:

• The actual amount charged by the provider;
• The negotiated rate;
• The usual charge which would have been made by a provider (Dentist, Hospital, etc) for the same or a comparable professional services, drugs, procedures, devices, supplies or treatment within the same Geographic Area, as determined by Us.

"Geographic Area" means the three digit zip code in which the service, treatment, procedure, drugs or supplies are provided; or a greater area if necessary to obtain a representative cross-section of charge for a like treatment, service, procedure, device drug or supply.

NETWORK PROVIDER FINDERS

AETNA DENTAL ACCESS® NETWORK

With nearly 112,000 providers the Aetna Dental Access PPO Network provides our clients with plenty of choice and quality.

Click here to access the Aetna Dental Access® Network to find participating dentists in your area.

Click here to nominate your dentist to be an Aetna Access® Provider

(Not available in AK, FL, ID, IN, ME, NH, NC, PA, WA and WY.)

*Dental counts as of February 2012, Aetna Enterprise Provide Database

Aetna is a brand name used for product and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates. The Aetna Dental Administrators program is powered by the Aetna Dental Access® network. This material is for information only. Information is believed to be accurate as of the product date; however, it is subject to change.

DENTEMAX DENTAL NETWORK

More than 151,000 Dentist access points.

Click here to access Dentemax Dental PPO

(Only available in AK, FL, ID, IN, ME, NH, NC, PA, WA and WY.)

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