Overview

Xerox supports you by offering a choice of comprehensive dental coverage through Aetna to help you maintain a healthy smile. You have the flexibility to choose the best option for you.

2022 dental plans

  • Basic Plan
  • Enhanced Plan
  • DMO Plan (Dental Maintenance Organization) (in some locations)
Key features

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In-network preventive and diagnostic care at no extra cost

Affordable coverage that helps you manage the cost of dental treatment

Wide network of providers that have agreed to negotiated rates, which helps you save money

All of the plans generally cover the same types of expenses, and they differ in how much you pay for care

The DMO Plan only covers care received from DMO network providers, and you will need to select a primary dentist from the network. If you’re considering the DMO option, be sure to check that your dentist is in the network before enrolling

 

Coverage Details

  Basic Plan* Enhanced Plan* DMO Plan
(Available in some locations)**
In-network  
Annual Deductible $75 per person (3 per family) $50 per person (3 per family) None
Diagnostic/Preventive Care (Limited to 2 preventive visits per calendar year)
Plan pays 100%, no deductible Plan pays 100%, no deductible Plan pays 100%
Basic Care Plan pays 60% after deductible Plan pays 80% after deductible Plan pays 100% of negotiated fees after $5 copay
Major Care Plan pays 50% after deductible Plan pays 50% after deductible Plan pays 60% of negotiated fees after $5 copay
Maximum Annual Benefit $1,000 per person $1,500 per person None
Orthodontia Plan pays 50% (no deductible) for children only (must be “banded” before age 20) Plan pays 50% (no deductible) for adults and children Plan pays 100% after $2,400 copay for adults and children
Maximum Lifetime Orthodontic Benefit $1,000 per person $1,500 per person 24 months of treatment plus 24 months of retention

*Out-of-network: Out-of-network services are based on reasonable and customary (R&C) charges.

**This plan only covers care received from providers in the DMO network. If you’re considering the DMO Plan option, be sure to check that your dentist is in the network before enrolling.

For cost and coverage details, visit BenefitsWeb.

Use Your Dental Benefits Wisely

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Choose a provider

Using a participating dentist in the plan network will ensure you receive the highest benefits from your plan. To find a provider, go to the Aetna website. If you enroll in the DMO Plan, you and each covered dependent will need to select a primary dentist from the DMO network (you may each select a different dentist).

Check your claim status and other information at Aetna.

You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.

Find a Dentist

You’ll generally pay less when you use an in-network dentist. To find an in-network provider near you:

  1. Go to the Aetna website.
  2. ​​​Continue as a guest.
  3. Enter your 5-digit zip code, city, state, or county.
  4. Choose your network:​
    • If you're enrolled in the Aetna Basic or Enhanced Dental Plan, search the "Dental PPO/PDN with PPO II" network.
    • If you're enrolled in the Aetna DMO Plan, search the "Aetna DMO/DNO" network.
  5. Select your plan and click "Continue."
  6. Enter what you need to search for or find what you need by category.​​