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Written by Shelley DeGroff, Founder & CEO of PPO Advisors

Last Updated: September 5, 2026

If your practice sees Aetna Medicare Advantage patients through the G.E.H.A. Connection Dental Network, your in-network status for those plans ends on January 1, 2027.

Connection Dental has notified network providers that its participation will no longer make them in-network for Aetna Medicare Advantage dental plans. It is the second leased pathway into these plans to close in about sixteen months, and the practices most affected do not realize they rely on this pathway at all.

Here is exactly what changes, the one fee schedule fact that decides the whole question, and the four outcomes your numbers can point to.

What Is Changing With Aetna Medicare Advantage on January 1, 2027?

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Effective January 1, 2027, participating Connection Dental Network providers will no longer be considered participating providers for Aetna Medicare Advantage dental plans. Read the notice carefully, because three separate things are true at once:

• Aetna Medicare Advantage is affected. As of January 1, 2027, Connection Dental participation no longer makes you in-network for these plans.
• Your Connection Dental participation is not affected. You remain a participating Connection Dental Network provider, and your agreement with the network continues.
• Aetna commercial is not affected by this notice. Aetna continues to access the Connection Dental Network for its Commercial PPO and PPO II dental plans. Those patients are unchanged, provided you do nothing.

The notice carves out only the Aetna Medicare Advantage piece. Everything else stays where it was. The catch, as the sections below explain, is that the obvious response to this notice does not leave everything else where it was.

 

Why Does This Change Matter More Than It Looks?

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This is the second leased pathway into Aetna Medicare Advantage to close in about sixteen months, and when it closes, only one door remains. Careington’s Care Platinum PPO stopped serving as an Aetna access point on September 1, 2025. Connection Dental follows on January 1, 2027. From that date, a direct contract with Aetna is the only way to be in-network for these dental plans.

There is a broader pattern behind this. Aetna, Humana, and UnitedHealthcare have all been reducing their Medicare Advantage footprints for 2026 and 2027 as margins tighten. At the same time, CMS’s 2025 final rule now requires Medicare Advantage organizations to submit provider directory data for publication, update it within 30 days of learning of a change, and attest annually to its accuracy, with that data feeding the Medicare Plan Finder.

A leased network is a difficult place to source a roster you have to personally attest to. Whatever the reasoning, the practical result for your practice is the same, and other carriers may follow.

 

Can You Join Aetna Medicare Advantage by Itself?

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No, you cannot join Aetna Medicare Advantage by itself, because Aetna does not offer a Medicare-only dental plan. PPO Advisors, a PPO negotiation and credentialing company for dental practices, confirmed this directly with Aetna before publishing. Medicare Advantage access is built into the Aetna PPO contract. There is no separate agreement to sign and no way to add it on its own.

That answers the questions practices have been asking:

• Can I join the Medicare Advantage plans directly and leave my Aetna PPO plans through Connection Dental? No. There is no standalone plan to join. Medicare access comes with the direct Aetna PPO contract.
• Can I be out-of-network for Aetna PPO but in-network for Medicare Advantage only? No, for the same reason. The two are not separable in that direction.
• Can I go direct with Aetna PPO and opt out of Medicare Advantage? Yes. Providers who contract directly with Aetna PPO can opt out of Medicare.

The opt-out runs one way. You can take the commercial contract without the Medicare Advantage plans. You cannot take the Medicare Advantage plans without the commercial contract.

 

Should You Trade Your Whole Aetna Book for a Handful of Patients?

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No, you should not sign a direct Aetna contract to protect a small Medicare Advantage patient base until you have priced what it does to every Aetna patient in your practice. This is the single most important section in this article, and it rests on two facts.

First: Aetna Medicare Advantage pays on the same fee schedule as your Aetna PPO contract. There is no separate Medicare Advantage fee schedule to evaluate, no different Medicare rate, and nothing to weigh independently.

Put those two facts together and the picture is clear. You are not deciding whether to add Medicare Advantage. You are deciding whether to move your entire Aetna book, commercial included, from the leased Connection Dental fee schedule onto Aetna’s direct fee schedule. The Aetna Medicare Advantage patients ride along on whatever that one number turns out to be.

For most practices, Medicare Advantage is the smaller book and Aetna commercial is the larger one. If Aetna’s direct schedule comes in below what Connection Dental pays you today, signing it to protect a handful of Medicare Advantage patients means accepting lower reimbursement on every Aetna patient in your practice. That trade is almost never worth making, and it is exactly what happens when a practice reacts to a network notice without running the numbers.

Run the comparison before you decide, not after:

• Step 1: Count both patient bases separately. How many active Aetna Medicare Advantage patients do you have, and what do they produce annually? Now the same two numbers for Aetna commercial PPO and PPO II. Expect the commercial side to be considerably larger.
• Step 2: Get the fee proposal in writing. Request Aetna’s direct fee schedule before you submit an application. This is the one number the whole decision rests on.
• Step 3: Compare it to what you actually collect. Not to your full fee, and not to what you assume the leased schedule pays. To your real numbers on real claims.
• Step 4: Apply it to the whole book, not the Medicare Advantage slice. Multiply the difference across every Aetna patient you treat. That total is what you are actually deciding.

 

What Else Does a Direct Aetna Contract Touch?

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A direct Aetna contract can change your effective fee schedule on plans far beyond Aetna, because dental contracts rarely sit in isolation. Networks are leased, shared, and stacked, and the arrangement that governs one carrier’s patients often runs through an agreement you signed with someone else entirely.

Before you sign, ask specifically:

• Which other payers reach you through these networks? A change in how you participate with one carrier can quietly change the effective fee schedule for plans you did not think were involved.
• What does your Connection Dental agreement still cover once Aetna is direct? Aetna PPO moves to the direct contract, but Connection Dental leases to other payers. Know which of your patients still come through that agreement and what they are worth.
• What is your resulting fee schedule across every affected plan? Not just Aetna. The number that matters is the one at the bottom of the whole portfolio.

This is difficult to map from inside the practice, because the agreements that control it are not all in your files. Sorting out what a direct Aetna agreement would do to your reimbursement across every plan is precisely the analysis PPO Advisors does.

 

How Long Does Direct Aetna Credentialing Take?

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Direct carrier credentialing typically runs 30 to 60 days, with no separate carrier loading period. Loading time is what you wait through when you credential into a carrier through an umbrella network, and going direct removes that step entirely.

Nothing carries over automatically from your Connection Dental participation, so a direct Aetna agreement is still a new application and new credentialing. Across 12,000+ credentialing applications, PPO Advisors has seen the realistic direct window hold at 30 to 60 days, not the much longer stretch an umbrella arrangement requires. That means you have room to do this properly. The analysis needs to start now. The application does not, and it should not until the analysis is finished.

Step	What Needs to Happen
Start this week	Confirm how you currently reach Aetna. If it is through Connection Dental, you are affected. Pull your Aetna Medicare Advantage and Aetna commercial patient counts and annual production separately.
Next, before you apply	Request Aetna’s direct fee proposal in writing. It is one schedule covering commercial and Medicare Advantage alike, and it will replace your Connection Dental rate for Aetna PPO. Ask what the direct contract does to every other contract in your practice.
Then decide	Compare the proposal against what you actually collect today, across your whole Aetna book and every other affected plan. Decide whether a direct contract improves your position or costs you money.
Only if the numbers support it	Submit the application. Allow 30 to 60 days for direct credentialing. Follow up in writing every two weeks and keep a dated record of every response.
Before January 1, 2027	Get your effective date confirmed in writing. Do not assume it, and do not schedule 2027 Aetna Medicare Advantage patients on the assumption.

Notice what is not on that list. Nowhere does it say submit an application because a deadline is coming. The urgency belongs to the analysis, not to the signature. A practice that takes the fall to review its numbers can still be effective early in 2027 if the math supports it. A practice that rushes a direct contract to beat January 1 and finds out afterward that it lowered reimbursement across its whole Aetna book has done damage that lasts far longer than a few months out-of-network.

If the numbers do not support a direct contract, that is a legitimate outcome and not a failure. Plan the transition, communicate with your Medicare Advantage patients early, and protect the reimbursement on the rest of your schedule.

 

Which of the 4 Outcomes Is Right for Your Practice?

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Depending on what your numbers show, any of these four outcomes can be the right answer:

• Go direct with Aetna and keep Medicare Advantage. Right when the direct fee schedule holds up across your whole Aetna book. Since the rate is the same either way, there is no reason to turn those patients away once you have accepted the schedule.
• Go direct with Aetna and opt out of Medicare. Right when the schedule works for your practice but you do not want the Medicare Advantage population, for reasons of case mix, scheduling, or administrative load rather than rate.
• Stay with Connection Dental and let the Aetna Medicare Advantage plans go. Right when your leased Connection Dental rate is better than Aetna’s direct schedule. You keep the larger book at the better rate and give up the smaller one. For many practices this is the correct answer, and it requires doing nothing at all.
• Negotiate before you decide anything. A fee proposal is a starting position, not a final offer.

What is not on that list is signing a direct agreement without knowing which of the four you are choosing. Network changes rarely arrive with enough lead time, and that pressure leads practices to sign agreements they have not evaluated. The practices that come through transitions well know exactly what every contract pays and where their patient exposure sits before the effective date arrives. PPO Advisors tracks changes like this one on the PPO Advisors blog.

 

The Bottom Line

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• Connection Dental participation stops counting as in-network for Aetna Medicare Advantage dental plans on January 1, 2027.
• From that date, a direct Aetna contract is the only way into these plans, and there is no Medicare-only version to sign.
• Aetna Medicare Advantage pays on the same fee schedule as Aetna PPO, and a direct contract supersedes your leased Connection Dental rate for all Aetna patients.
• The real decision is whether to move your entire Aetna book to the direct schedule, not whether to keep a handful of Aetna Medicare Advantage patients.
• Direct credentialing runs 30 to 60 days with no loading period, so there is time to run the numbers before signing anything.

 

Frequently Asked Questions About the Aetna Medicare Advantage Change

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Can I join Aetna Medicare Advantage directly and keep Aetna PPO through Connection Dental?

No, there is no standalone Aetna Medicare Advantage dental plan to join. Medicare Advantage access is built into the direct Aetna PPO contract, and that direct contract supersedes your Connection Dental arrangement for Aetna PPO, so the two cannot run side by side.

 

Can I be out-of-network for Aetna PPO but in-network for Aetna Medicare Advantage only?

No, a practice cannot be in-network for Aetna Medicare Advantage while out-of-network for Aetna PPO. The plans are not separable in that direction. The only one-way option runs the other way: a direct Aetna PPO provider can opt out of Medicare.

 

Does Aetna Medicare Advantage pay a different fee schedule than Aetna PPO?

No, Aetna Medicare Advantage pays on the same fee schedule as the Aetna PPO contract. There is no separate Medicare rate to evaluate, which is why the real decision is what the direct schedule does to your entire Aetna book, not to the Medicare Advantage patients alone.

 

Do I have to do anything before January 1, 2027?

Yes, every practice reaching Aetna through Connection Dental should run its numbers this fall: count Aetna Medicare Advantage and commercial patients separately, request Aetna’s direct fee proposal in writing, and compare it to real collections. Signing is only the right move if that comparison supports it, and doing nothing is a legitimate outcome when the leased rate is better.

 

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✍️ Shelley DeGroff
Founder, PPO Advisors