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| Dental | Cost to Employee |
|---|---|
| Individual/Family Deductible Per Calendar Year | $100/$300 |
| Dental Annual Maximum Coverage Per Person | $1500 |
Diagnostic and Preventative Care | Type A - No Charge |
| Basic Restorative | Type B - 20% after deductible |
| Major | Type C - 50% after deductible |
| Orthodontic | 50% for child only, with a $1500 lifetime maximum |
| Info | ||
|---|---|---|
| ||
US In-Network Dental services: Services are direct-billed by the provider, if you use a dental provider within the Aetna Dental PPO Network. US Out-of-Network and Outside of the US: You can visit any licensed dentist . Simply pay your charges at the time of service and submit a claim form to Aetna for reimbursement. |
| UI Expand | ||
|---|---|---|
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Outside U.S.The Aetna Deductible for expenses outside of the U.S. is $0. Aetna has direct-bill relationships with 168,000 medical providers outside the United States. If Aetna does not already directly bill your current doctor, Aetna will establish a relationship with your current doctor or clinic to set up direct billing. U.S. In-NetworkThe Aetna Deductible for expenses incurred in the U.S. In-Network is $2,000 employee/$4,000 family (employee + spouse, child, or family). In the United States, Aetna has Preferred Provider Network (PPO). After reaching your deductible, Aetna covers most* medical costs at 100% (see the Plan Summary for additional details on the types of medical expenses covered under Aetna's plan). *Some co-pays pay still apply after the deductible is met. Please see restrictions for non-emergency use of emergency room and urgent care services, as additional out of pocket costs may apply. U.S. Out-of-NetworkExpenses incurred from a U.S. Out-of-Network provider will count toward a separate additional deductible of $2,000 employee/$4,000 family (employee + spouse, child, or family) If you incur expenses from a U.S. Out of Network provider after you reach your plan deductible, Aetna covers 20% or 50% of expenses depending on the type of medical expense. |
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