How the Dental Plans Work

SAIC offers participants a choice when it comes to choosing the type of dental plan that works best for the participant and his or her family.

With the SAIC Dental PPO Plan, a participant can use any dentist he or she wants. However, when a participant uses dentists who participate in the Aetna PPO network, he or she will receive a higher level of benefits and pay lower out-of-pocket costs. This is because Aetna (www.aetna.com) network providers have agreed to charge lower, negotiated fees for services. When a participant uses dentists outside the Aetna network, he or she will receive a lower level of benefits and pay higher total out-of-pocket costs.

A Dental Health Maintenance Organization (DHMO) works just like a health maintenance organization, or HMO. There is no deductible, and there are no claim forms to file. Participants must choose a network provider, who will coordinate and provide dental care services at a fixed cost. If a participant does not coordinate his or her care through the primary care dentist, the plan will not pay benefits. DHMOs are available only in areas where there are participating dentists.

Please carefully review the sections pertaining to what the dental plans will and will not cover to find information on the dental plan exclusions. Additionally, the individual dental plan carriers should be contacted for information on the specific exclusions for dental work in progress.