Greeley-Evans School District 6
School District
Aetna Dental Cost and Benefits
Dental Benefits Cost
| Individuals Covered | Monthly Premium | Your Cost per Month |
|---|---|---|
| Employee Only | $35.00 | $0.00 |
| Employee + Spouse | $67.00 | $32.00 |
| Employee + Child(ren) | $80.00 | $45.00 |
| Family | $120.00 | $85.00 |
Dental Services Cost
| Type of Service | In-Network | Out-of-Network |
|---|---|---|
| Policy Year Deductible | $50 per individual / $100 per family | $50 per individual / $100 per family |
| Policy Year Maximum | $1,500.00 | $1,500.00 |
| Dependent Eligibility | To age 26 | To age 26 |
| Preventative | 100% | 100% |
| Basic Services - Periodontics/Endodontics | 80% | 80% |
| Major Services | 50% | 50% |
| Orthodontics | 50% | 50% |
| Orthodontics Lifetime Maximum | $1,500.00 per eligible person | $1,500.00 per eligible person |
| Orthodontics Age Limitation | Dependent children to age 19; no adult coverage | Dependent children to age 19; no adult coverage |
You will not receive an ID card, but if you are enrolled in medical, your member ID for medical and dental are the same. If you are only enrolled in dental, you will receive a letter that includes your dental information, including member ID. You can also find your dental information by logging onto the member website at www.aetna.com or through the Aetna mobile app.
What is "balance billing"?
- Balance billing is additional amounts a non-participating (out-of-network) dentist charges you for the difference between the dental carrier's allowed amount and the dentist's fee.
- Participating (in-network) dentists agree to accept the dental carrier's allowed fee and charge you only the copays and deductibles, when applicable.
- Non-participating (out-of-network) dentists may charge you the difference between the dental carrier's allowed amount and their fee and may also require you to pay the full charge up front.