Dental
Dental Overview
Choose the plan that’s right for you; watch the Dental Overview video.
Seeing your dentist regularly might be one of the best defenses against serious illness. It’s not just for good oral health — it’s for good overall health.
You can choose from three dental options, depending on where you live:
Aetna Basic Dental PPO Option: Covers basic restorative and preventive dental services only. Use any dentist you want; you’ll pay less when you choose a network provider.
Aetna Enhanced Dental PPO Option: Covers basic restorative, preventive and major dental services as well as orthodontia. Use any dentist you want; you’ll pay less when you choose a network provider.
The Aetna DMO® Option: Generally covers similar services as the Enhanced option. Use DMO network dentists only. Important: You must select a primary care dentist if you’re enrolling in this plan for the first time. Confirm that your dentist is in-network before selecting this plan.
If you newly enroll for CVS Health coverage, you’ll receive a new Aetna member ID card in the mail.
To find dental providers in the Aetna network, use the Aetna online provider directory on www.aetna.com or call 1-877-566-1135.
| Aetna Basic Dental PPO | Aetna Enhanced Dental PPO | Aetna DMO* |
|---|---|---|
| Learn More | ||
| Basic Dental | Enhanced Dental | DMO Dental |
| Deducible | ||
$50 per person per plan year, up to a maximum of $150 for the plan year |
$50 per person per plan year, up to a maximum of $150 for the plan year |
No deductible |
| Annual Plan Maximum | ||
$1,000 per person per plan year |
$2,000 per person per plan year |
No limit on the amount the plan pays |
| Preventive Care Services | ||
Plan pays 100%; deductible does not apply |
Plan pays 100%; deductible does not apply |
Plan pays 100% |
| Basic Restorative Services | ||
You pay 40% coinsurance, after satisfying deductible |
You pay 20% coinsurance, generally after satisfying deductible |
You pay 10% coinsurance |
| Major Services | ||
Not covered |
You pay 40% coinsurance, after satisfying deductible |
You pay 40% coinsurance |
| Implants | ||
Not covered |
You pay 40% coinsurance after satisfying deductible, up to the $2,000 annual plan maximum; check with plan for additional information |
You pay 40% coinsurance |
| Ortodoncia | ||
Not covered |
You pay 40% coinsurance; plan pays orthodontia lifetime maximum of $2,000 |
You pay a $2,400 copay per member; no lifetime maximum for orthodontia |
*You’re only covered for services from dentists in the Aetna DMO network. Before you enroll, make sure there is a network dentist in your area. You don’t have to file claim forms in the Aetna DMO or when you see a PPO network provider.
Tip: See a more detailed side-by-side comparison of your dental plan options “at a glance” on the enrollment website. From the Dental section of the enrollment page, select View Plan Options, then View All Plans Side-by-Side.
Important Information about Orthodontia Coverage
If you or a covered family member is currently in a course of orthodontic treatment and considering switching dental plan options, here’s how benefits work:
If You Plan to Enroll in the CVS Health Aetna DMO Option
If you were covered under the CVS Health Aetna Enhanced Dental PPO option when the treatment began, orthodontic benefits will continue under the CVS Health Aetna DMO, subject to plan limits. The $2,400 copay will be prorated based on the number of months remaining for treatment.
If you were not covered under a CVS Health dental plan or you were enrolled in the CVS Health Aetna Basic Dental PPO option when the treatment began, the plan will not pay benefits for your continuing orthodontic treatment. If you or a family member starts orthodontic treatment after your coverage is effective in the CVS Health Aetna DMO, that treatment will be covered.
If You Plan to Enroll in the CVS Health Aetna Enhanced Dental PPO Option
If you are currently covered under the CVS Health Aetna DMO, orthodontic benefits will continue, subject to plan limits of the CVS Health Aetna Enhanced Dental PPO option.
If you are not currently covered under a CVS Health dental plan or you are currently enrolled in the CVS Health Aetna Basic Dental PPO option, the plan will not pay benefits for your continuing orthodontic treatment. If you or a family member starts orthodontic treatment after your coverage is effective in the CVS Health Aetna Enhanced Dental PPO option, that treatment will be covered.
Note: Orthodontic treatment is not covered by the Aetna Basic Dental PPO option regardless of when treatment begins.
Learn more about Orthodontia coverage Learn more about Alternative Orthodontics for Members
