questions? call 1-800-494-9294

With your Aetna Vital Dental Savings℠ Plus Rx you’ll enjoy average discounts of 15-50%* on dental procedures at over 131,000 available dental practice locations nationwide. Your plan provides you with access to one of the largest dental discount networks in America.

Quick Reference Guide to Your Plan

Questions? Call 1-800-494-9294

Your Plan Provides Savings on These Benefits

Healthy Smile, Healthier You!

Questions? Call 1-800-494-9294Get More Info: DentalPlans.com/members

Prescription Discounts. 10% to 40% of the average price of prescription drugs . For Cost Estimates, visit aetnanavigator.com

Your plan also includes a comprehensive bundle of bonus benefits that provide you with significant healthcare savings:

Vision Discounts . Vision savings offered through EyeMed Vision Care -Call 1-800-793-8616 and Use Group #47169. Ready for LASIK? Call 1-877-552-7376

Hearing Discounts . Your savings include discounts on hearing exams, hearing services and hearing aids through Amplifon. . Call Amplifon at 1-866-211-6045

You can find out more about these bonus benefits at dentalplans.com/members.

Remember that the Aetna Vital Dental Savings℠ Plus Rx Program is not insurance. Savings plans work differently than traditional insurance.

Basic/Preventive Restorative Orthodontics

Cosmetic Dentures/Implants Oral Surgery


Select Your DentistYou’ll find everything that you need to make the most of your Aetna Vital Dental Savings℠ Plus Rx, plus special savings and perks, in the Member’s Area. Your first step towards saving is to select your dentist. Follow the easy to follow steps below to search and select your dentist.

Visit DentalPlans.com/members, and log in with your email and password. (Forgot your password? No problem, it’s easy to reset it on the log in page.)

If you haven’t already done so, please link your dentist to your account. You can easily do this by clicking “Find a Dentist”. Here you can either locate your dentist, or find nearby dentists who accept your plan. Just click “Add Dentist” to add the dentist’s info to your Member’s Area.

You can add as many dentists as you choose, and you can always opt to see any dentist – anywhere in the nation – that accepts your plan!

The Member’s Area also includes information on how to use and renew your plan, your plan’s documentation, a tool to help you track your dental savings, and special offers for health and wellness services and products.

Questions? Call 1-800-494-9294 Get More Info: DentalPlans.com/members

See How Much You Will SaveA dental fee schedule lists the discounted prices that members of your dental plan pay for dental services. Obtain a copy of your Aetna Vital Dental Savings℠ Plus Rx fee schedule by logging into the DentalPlans.com Member’s Area. Fee schedules for Aetna Dental Access are specific to the dentist you have selected. After you have selected a dentist, click on “Fee Search” to view the fee schedule for your selected dentist.

ADA codes (also known as “Dental Procedure Codes ) are numerical codes that are used by insurance companies, dentists and government agencies to help ensure consistency in dental records. There is a code for every dental procedure, and the codes are used

nationwide. Dental procedures associated with each code are listed on your fee schedule under the “Description” column. When your dentist tells you what treatments you need, you can ask for the ADA codes. If your dentist provides you with a treatment plan, the codes for each recommended procedure will be listed. The reduced fees that you pay for each procedure are listed in the right-hand column, underneath the type of service.

It’s a good idea to log into your account periodically to ensure you always have the most recent fee schedule. If you have any questions, please call 1-800-494-9294 to speak to a member of the :DP AtYourService® team.

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As you know, your plan enables you to access a network of dentists who offer reduced fees to plan members. Here’s a quick reminder of how to use your plan to save directly at the dentist:

1. Make a dentist appointment, and provide the dental office with the name of your dental savings plan - Aetna Vital Dental Savings℠ Plus Rx.

2.Take your membership card with you to the dentist.

3. You can get information about the savings you’ll receive for any treatment by calling the :DP AtYourService® Team at 1-800-494-9294. We’ll need your dentist’s name and the ADA codes for each treatment your dentist recommends.

4. Pay the discounted fee directly to your dentist. No claims to file, and no waiting for reimbursement with your dental plan!

5. After your visit, don’t forget to return to your Member’s Area and enter your savings in your :DP SavingsTracker! That way you can keep track of how much you’re saving with your plan.

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THIS IS NOT INSURANCE.It is a reduced fee plan. Payment is due at the time of service.

Dental RXSavings Plan

Contact Us: Monday - Friday 8am - 8pm ESTPlan Members: Call (800) 494-9294

Providers: Call (855) 232-3466 or visit www.DPVerify.com

Aetna VisionSM Discounts Plan #47196 Pharmacy Questions: (888) 792-3862

The Aetna® Vital Savings by Aetna Dental Discount Program® is a product marketed by :DentalPlans.

Present this ID card at the time of service. Participants are solely responsible for all charges incurred under these programs. Program providers are solely responsible for the products and services they provide. Aetna® Vital Savings by Aetna Dental Discount Program® and Aetna Dental Access® are service marks of Aetna. This program is o�ered by

Aetna Life insurance Company.

APNASM®

Use Your Plan


DISCLOSURESThe Aetna Vital Dental Savings℠ Plus Rx program (the “Program”) is not insurance. The Program provides Members with access to discounted fees. The discounted fees are negotiated by Aetna Life Insurance Com-pany for the Aetna Vital Dental Savings℠ Plus Rx discount program. Under the Program:

· Each Member must make payments directly to the providers participat-ing in the Program.· Each Member must pay for all services or products.· Each Member will receive a discount from the providers who have con-tractedwith the Discount Medical Plan Organization to participate in the Program.· Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156 is the Discount Medical Plan Organization, telephone number.The following terms and conditions of participation in the Vital Savings by Aetna® program (the “Program”) apply to:· the enrollee whose name is listed on the Vital Savings by Aetna® ID Card and· any dependent whose name is listed on the Enrollment Form.

Any limitations, exclusions, and exceptions that apply to the Program are part of this Member Agreement.

1. There are no benefits payable to Members. Aetna does not pay pro-viders for services they may give to Members. Aetna is not an insurer, guarantor or underwriter of any services given under the Program or of any payments to providers. Members arrange for needed care (and for the payment) directly with the provider. Members are responsible for the entire cost of the care. Aetna is not liable for any payment to a provider accessed under the Program.

2. Processing Fee: A processing fee in addition to the Membership fees in the Plan is applicable in the following states: Alabama, Alaska, Arizo-na, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missis-sippi, Missouri, New Jersey, New Mexico, Nebraska, Nevada, New Hamp-shire, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyo-ming. This processing fee is non-refundable except in those states listed below in the Cancellation and Refund Policy.

3. Membership Term: If the Membership fee and any non-refundable pro-cessing fee is paid and received, a Member will be entitled to all Services for the Membership term applicable at the time of purchase. The Mem-ber will receive a Plan activation notice with such activation commencing within 72 hours of the purchase and remaining in force as long as Member continues to pay required Membership fees and otherwise complies with the terms of this Agreement.

4. Automatic Renewal of Membership Term: Membership will be auto-matically renewed up to 30 business days prior to the expiration date of the Member’s Plan unless the Member notifies customer service, either by telephoning a customer service representative at the number on the Membership ID card or by providing written notification prior the new Membership term at the address below, that he/she wishes to cancel his/her Membership in the Plan. Setting an account to “Do Not Renew” is a sufficient form of notification to avoid automatic renewal. If the Member either fails to notify customer service of his/her election not to continue the Membership, Membership in the Program will be renewed automat-ically and the Membership fee for an additional term will be charged to the Member’s originalpayment source unless other payment methods are arranged.

5. Cancellation and Refund Policy: If a Member cancels his or her Mem-bership within the first 30 days after the effective date of enrollment in the plan, the Member will receive a full refund after notification of cancel-lation is provided to customer service. Arkansas members who cancel a

Member’s Agreement

membership within the first 30 days after the effective date of enrollment in the plan will receive a full refund, inclusive of the processing fee. To en-sure a cancellation request is processed, the Member must call a custom-er service representative at the number on his or her Membership ID Card. The applicable refund will be made within 30 days of receipt of the notice of cancellation. In the state of South Carolina only, a member shall receive a full refund of Membership fees, if Membership is cancelled within the first 30 days after receipt of Membership materials. After 30 days of initial purchase, the Refund Policy is as follows: A Member is eligible to receive a pro-rated refund only if a Membership is cancelled by DentalPlans.com or Aetna for any reason, if discounted savings are not realized on care delivered, or if the fee schedule of the Plan is not honored by at least one Provider in your vicinity. Pro-rated refunds will not be issued for any other reason, including nonpayment of fees by the Member. Applies to Auto-matic Renewals Only: In the event that the Plan has been automatically renewed following your initial purchase and provided that Services have not been used, a full refund will be issued within the first 60 days of the automatic renewal. If the Member does not desire the Plan to renew au-tomatically, the Member must set their account to “Do Not Renew.” After 60 days from the automatic renewal, the above refund policy applies. For residents of Oklahoma and North Dakota: After 30 days of initial purchase, the cancellation and refund policy is as follows: A Member is eligible to receive a pro-rated refund for any reason, including if discounted savings are not realized on the Services, or if the fee schedule of the Plan is not honored by at least one Provider in your vicinity. Pro-rated refunds will not be issued for the nonpayment of fees by the Member.

6. If the Member does not follow the terms and conditions of this Member Agreement, itmay result in an immediate end of the Member’s participa-tion in the Program. This includes,but is not limited to, failure to make payments to providers in a timely manner.

7. Providers are private contractors. Providers are not employees or agents of Aetna LifeInsurance Company and/or its parents, subsidiaries or affiliates (“Aetna”). The availability ofany particular provider is not guar-anteed. The list of providers in the network may change without notice. Aetna does not provide treatment under the Program. Aetna is not re-sponsible for Program or treatment outcomes. In consultation with the Member, the treating provider is responsible for all discounted services. Choice of the provider is also the responsibility of the Member and is not based on any representations by Aetna.

8. Providers participating in the Program have agreed to make certain services and supplies available to Members on a “discounted service” basis. The term “discounted service” means a service that is available to a Member at a lower cost from fees normally charged by the provider. All payments to providers are due and paid by the Member. Payments are made at the time of service, unless another payment arrangement is agreed on between the Member and the treating provider. Members are subject to the treating provider’s late payment and other office policies.

9. In order to get discounted service rates, a Member must show his/her Program ID card to the provider’s office at the time of his/her appoint-ment. A Member’s participation in the Program may end immediately if he/she gives his/her Program ID card (or otherwise provides unauthorized access to the Program) to any ineligible person.

10. The Program provides access to discounts from providers participating in the Program. Aetna may also, from time to time, and in its sole dis-cretion, provide Members with access, at no additional charge, to addi-tional programs. These additional programs offer access to health-related services at discounted or special rates. Any such programs are offered by independently contracted vendors/providers who are not employees or agents of Aetna or its affiliates. The providers of such “value-added” services are solely responsible for the products/services they provide. Providers included in such value-added programs are not credentialed by Aetna. Aetna may receive a percentage of the fee paid to the providers of the additional programs.

11. The Discount Medical Plan Organization offering the Program is Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156. The


Member’s AgreementProgram may not now, or in the future, be available in all states. Aetna has the right to end the Program in whole or in part, in any state(s) or other geographic location(s) with 30 days’ prior written notice to Members.

12. Member’s Plan Charge may increase if he/she changes from a single to a family plan. Members may add or remove family members by contact-ing Aetna at 1-800-494-9294. Members may also change from monthly to annual billing. A Member’s Plan Charge may be increased upon 45 days’ written notice from Aetna to the Member.

13. Aetna reserves the right to end a Member’s participation in the Pro-gram with 30 days’ prior written notice, for any reason. Otherwise, the term of this Member Agreement starts according to the date the Member ID Card became effective. The Member Agreement will stay in effect until it is canceled by the Member or Aetna.

If, for any reason, you are not totally satisfied:· notify us within 30 days of your effective date, and· we will fully refund your money minus the processing fee*.

The processing fee and rates charged for the program are listed on the Aetna Vital Dental Savings℠ Plus Rx Enrollment Form. Once you cancel, you do not have to make any further payments and you will no longer be entitled to discounts for any time after your last payment.

Aetna has a process for resolving complaints. Members may submit a complaint at any time.

To submit a complaint:· Call: 1-800-494-9294 or· Mail a written complaint to: Aetna Life Insurance Company, Customer Resolution Team, c/o DentalPlans.com, 8100 SW 10th Street, Suite 2000, Plantation, FL 33324.· Members may also contact their state insurance department, if they re-main dissatisfied after completing Aetna’s complaint resolution process.

While this material is believed to be accurate as of the print date, it may change. Aetna will tell the Member in writing 45 days in advance of any change to the Program. Aetna Vital Dental Savings℠ Plus Rx is a registered trademark of Aetna Inc.

· If you have questions about the Vital Savings dental by Aetna® program, our dedicated team of trained service professionals will help you. Please call 1-800-494-9294. For TDD (hearing and speech impaired only), call [1-800-234-3730· Incomplete applications cannot be processed.· Once submitted, enrollment data can only be changed by calling the Vital Savings Customer Service c/o DentalPlans.com at 1-800-494-9294.

VSA-MA-DP-1014




Healthy Smile, Healthier You!Medical science continues to find important connections between oral health and overall wellness. Taking good care of your teeth and gums is critical to maintain optimal health. Follow the tips below and talk to your dentist or hygienist to learn how to keep your smile healthy and strong.

1. Brush with a soft toothbrush, 2 minutes per mouth quadrant (top left and top right, bottom left and bottom right), at least twice a day.

2. Floss daily.

3. Limit sugar intake. If you do indulge in a sweet treat, avoid sticky or hard candies as they expose your teeth to sugar longer than a chocolate bar or similar snack does.

4. Acidy drinks, such as fruit juices, may also damage teeth. Rinse your mouth with water afterwards. Avoid brushing immediately after drinking as the acid may temporarily soften your tooth enamel.

5. Chewing sugarless gum helps promote saliva production, which assists in keeping your mouth healthy.

6. See your dentist regularly for checkups & cleanings.

7. Use your plan! Every dollar spent on preventive oral care can result in up to $40 in savings on future dental costs, according to the American Dental Hygienists’ Association.


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