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Retiree Dental

Here is a high-level overview of the 2024 Retiree Dental Plan administered by Aetna. The plan offers significant cost savings when you use providers in Aetna’s Dental PPO/PDN with the PPO II network.

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Eligibility

Generally, you are eligible for retiree dental benefits if you are age 55 or older and have 10 or more years of Oxy service. If you enroll, you may also cover your

. Review the Oxy Retiree Dental SPD for other eligibility requirements that may apply.

Plan Features

  Aetna Dental

 

What You Pay
Annual Deductible
  • Individual: $50
  • Family: $150
Annual Maximum $2,000 per covered individual per calendar year
Lifetime Maximum Unlimited (except orthodontic)
Lifetime Orthodontic Maximum $2,500 per covered dependent under age 19

Covered Services

  Aetna Dental

 

What You Pay

Preventive and Diagnostic Services

  • Routine oral exams (2 per year)
  • Teeth cleaning/scaling (3 per year)
  • Bitewing and diagnostic X-rays
  • Fluoride application (dependents under age 16)
  • Sealants
  • Space maintainers
  • Problem-based exams
 Covered 100%, no deductible

Restorative Services

  • Simple extractions
  • Some oral surgeries (e.g., wisdom teeth extraction) if not covered by your medical plan
  • Fillings, except gold
  • Repair of crowns, inlays, bridgework, dentures
  • Relining of dentures
  • Periodontics (e.g., treatment of gum diseases and tissues of the mouth)
  • Endodontic treatments such as root canals
  • General anesthesia, if medically necessary
 20% after deductible

Major Services

  • Crowns, inlays or gold fillings
  • Dentures
  • Fixed bridgework (including inlays and crowns as abutments)
 50% after deductible

Orthodontic Services for Dependents Under Age 19

 50% after deductible
Up to a lifetime benefit of $2,500

Vital Savings by Aetna

As an alternative to the Retiree Oxy Dental Plan, you can enroll in Vital Savings by Aetna. This program offers discounts on dental care through the Aetna Dental Access Network.

You have three ways to join the program:

  • Online: Go to the Vital Savings by Aetna website and use promotion code: 882016-018.
  • By phone: Call 888-238-4825.
  • By mail: Complete the Vital Savings Enrollment Form and mail it to the address on the form.