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In-Network Service

Aetna, the Dental Claims Administrator, has contracted with certain dental providers for utilization by Plan Participants. The dental hygienists who operate under the supervision of the contracted dentists for certain specified services are also part of the Network Dental providers.

  • The Network. The Aetna Dental Network which has been contracted for the MILA Dental Plan is the “PPO/PDN with PPO II Network."
  • Discounted Fees. The Aetna providers have agreed to charge MILA and MILA Members discounted service fees for the services covered in the MILA Dental Plan. If a Member negotiates for additional services that are not covered under the MILA Dental Plan from a Network dentist, that dentist may provide the Aetna discount on those other services if his/her Aetna contract requires that he/she do so. However, some dentists operate under contracts where they do not have to extend uncovered services at a discount. You should obtain a Pre-Treatment Estimate and discuss with your dentist the fees that will be charged before agreeing to any dental work that is not covered by the Plan.
  • Pre-Treatment Estimate. If you are to receive Basic or Major dental treatment that is expected to be extensive or to cost more than $300, it is always a good idea to obtain a pre-treatment estimate of the work that is to be done and what it will cost. The description of the dental treatment and its proposed cost will be completed by your dentist and sent to Aetna for the fees to be checked and Aetna will prepare an estimate of the charge for which you will be responsible and send it to your dentist. If the total cost of the work and the benefits payable by the Plan are expected to exceed the individual’s annual maximum, you may want to discuss having some of the work done over time to increase the total amount that the Plan will cover. Also, if the Plan will cover only the cost of an alternate treatment plan, you may discuss with your dentist whether that alternate treatment might achieve a satisfactory result.