DMO® (Dental Maintenance Organization®)

2008 DMO Plan Schedule

With the Dental Maintenance Organization (DMO) plan, participants are covered for a broad range of services. Unlike the PPO plan, where coinsurances against PPO fee schedules and reasonable charges will determine your copayment, your copayment (if applicable) for covered services under the DMO plan are "fixed" and will be based on a "fixed" schedule. In order to take advantage of covered benefits, participants must select a participating Primary Care Dentist from Aetna's list of participating dentists. Each family member can select a different participating Primary Care Dentist (PCD). The Primary Care Dentist, who is the key to the participant's dental care, provides and coordinates care by referring patients to a dental specialist as appropriate under the terms of the plan. It is important to understand that a referral from your PCD is required and that services obtained without a referral from your PCD will not be covered. If you live in California or Arizona and do not elect a Primary Care Dentist, one will be automatically assigned to you; otherwise, if you do not elect a Primary Care Dentist, the plan will not cover any services.

The DMO network is smaller when compared to the PPO network. However, there are over 31,000 DMO providers nationwide, making Aetna's network the largest in the country. In the DMO plan you will generally not be covered for services with Non-Participating Dentists.