Aetna Dental Plan: DMO vs. Secure T (PPO) which one is better?

I'm being offered Aetna dental plan by my employer during the open enrollment period. This is my first time getting the dental insurance for myself and my spouse. We both need extensive work that would cost around $3500 each. I don't know which plan is better for us and would save us money. I would really appreciate your advice. The Secure T plan has an annual deductible of $50 (individual) and $100 (family). Annual Maximum is $1,500/individual. There is no copay for office visit and it covers 100% preventive care, 80% Basic Services, and 50% major services after deductible. The Aetna DMO uses only DMO dentists. There is no calender year deductible and annual maximum. There is $5 copay. Preventive Care: No charge (copay may apply to certain procedures); Basic Services: covered after applicable copay (copay varies by procedure); and Major Services: covered after applicable copay (copay varies by procedure). I don't know what annual maximum and calender year deductible mean. If I choose to go with DMO, would I covered for basic and major services after $5 copay? I don't understand insurance plans as it is my first time applying for one. Please help!
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The annual maximum is the most the policy will pay, regardless of how much work you have done. The calendar year deductible is the amount you have to pay out of your own pocket each year, before the insurance company pays anything. In your case, you have $3500 of work ahead of you. Under the Secure T plan, you have an annual deductible of $50. That means that the first $50 of charges for the year are not covered--you pay them. After that, they pay 50 percent of "major services," which probably includes whatever it is that you are having. You pay the other 50 percent. So, to break it down a little bit, look at the first $1000: you pay $50 (that deductible) plus 1/2 of the remaining $950, or $475. The insurance pays $475. For the next $1000, you each pay 1/2, that is, $500. Third thousand, is the same--$500 each. But at this point, the insurance will have paid $450 + $500 + $500, or $1475. The maximum is $1500, so for the rest of your expenses (the last $500), they will pay only $25. After they get to that point, everything else is on you. Also, your question says they pay 50% "after deductible," so check to see if there is a *second* deductible that applies to major services, separate from the annual deductible. For the Aetna plan, there is no annual deductible. Instead, they work on a copay basis, which means you pay part of the cost for each procedure. You will have to look at their schedule to see what the copays are for the procedures you are facing. It is not as simple -- or as cheap -- as just paying $5 copay per visit. There is an additional copay per procedure. Yeah, it's complicated, but I hope this helps.
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