Dental Benefits

Three Dental Plan options are available to choose through Aenta.

The GW dental plans are “stand-alone” plans, so you can enroll in dental coverage whether or not you have medical coverage through GW.   

You don’t need a dental ID card to get dental care. When you visit your dentist, simply tell the office your name, date of birth and member ID number (or your Social Security number).

The Aetna group number for GW is 622758. 

As with any Preferred Provider Organization (PPO) plan, the Aetna Dental Low PPO plan is designed to provide you with a greater level of coverage for using service providers within the Aetna network. Some coverage is available for providers outside the Aetna network; however any services you receive from an out-of-network provider will be paid only at the “Reasonable and Customary” amount. The Low Option provides you with preventive and basic coverage and has a lower premium.

Overview

Aetna has prepared two helpful documents for your review. The Low PPO Plan Summary (PDF) (PDF) provides summary information on coverage and services. The Low PPO Benefit Booklet-Certificate (PDF) provides an in-depth look at what your plan covers and how benefits are paid.

The Aetna Dental High PPO plan is designed to provide you with a greater level of coverage for using service providers within the Aetna network. This plan carries a higher premium.  Some coverage is available for providers outside the Aetna network; however any services you receive from an out-of-network provider will be paid only at the “Reasonable and Customary” amount.

Overview

The High PPO Plan Summary (PDF) provides summary information on coverage and services. The High PPO Benefit Booklet-Certificate (PDF) provides an in-depth look at what your plan covers and how benefits are paid.

You also have the option of selecting coverage through the Aetna Dental Maintenance Organization (DMO), which provides benefits in a similar manner to an HMO medical plan. You must elect a Primary Care Dentist (PCD) from within the Aetna network to coordinate all your dental care.

If your PCD believes you need to visit a dental specialist, he or she will refer you to a specialist in the DMO network. The DMO does not provide coverage outside the Aetna network. There is no deductible to meet under the DMO, nor is there an annual maximum coverage amount. Office visits require a $5 copay. Orthodontic services are available for both adults and children, and require a $2,300 copay.

Overview

The DMO Plan Summary (PDF) provides a list of procedures, codes and amounts paid by the patient. In addition, it outlines plan exclusions and limitations.

The DMO Benefit Booklet-Certificate (PDF) provides an in-depth look at what the plan covers and how benefits are paid.

Aetna has also prepared a DMO Myths & Facts Information (PDF) to highlight five common myths about managed dental benefits and insurance plans.

Contribution rates for full- and part-time employees is broken out by the employee's type of coverage.

The Aetna Dental Claim (PDF) will need to be completed for any out-of-network claim and/or if you do not have your card with you at the time of purchase and need to have claims reprocessed after receiving a card.

International dental services (PDF) for Aetna PPO and DMO Plans are available.