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Written by Shelley DeGroff, Founder & CEO of PPO Advisors

Last Updated: October 8, 2026

The smartest PPO consulting move you can make before January 1, 2027 is deciding on purpose whether United Concordia’s new Aetna partnership should apply to your practice. If you do nothing, the decision gets made for you.

United Concordia (UCCI) has begun mailing letters to its Medicare Advantage participating dentists announcing a new partnership with Aetna. Starting January 1, 2027, Aetna Medicare Advantage members will have access to United Concordia’s National Medicare Advantage Network, and participating offices will be paid on their United Concordia Advantage Plus fee schedule. Like every shared network agreement, this one is automatic. PPO Advisors, a PPO negotiation and credentialing company for dental practices, has reviewed the letter, and for most offices the default is not the outcome they would choose. This is a PPO consulting decision disguised as an FYI letter.

Here is what the letter says, who it reaches, why the fee schedule decides everything, and what a PPO consulting review should settle before the effective date.

What Does the United Concordia Letter Actually Say?

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The letter, titled “NEW Partnership with Aetna,” says that effective January 1, 2027, the Aetna Dental PPO Network will include United Concordia’s National Medicare Advantage Network, with participating offices paid on their current Advantage Plus Maximum Allowable Charge Schedule. It gives offices the working details for treating these patients:

Item	Details From the Letter
Effective date	January 1, 2027
Network	Aetna Dental PPO Network, which now includes United Concordia’s National Medicare Advantage Network
Reimbursement	Your current United Concordia Advantage Plus Maximum Allowable Charge Schedule
Electronic claims	Payer ID 60054
Paper claims	Aetna Medicare, PO Box 981106, El Paso, TX 79998-1106
Aetna customer service	(800) 624-0756
ID cards	Some cards show Medicare HMO on the front. HMO refers to the medical plan only; all Aetna Medicare plans use a dental PPO network

Where it does not apply. The partnership excludes Delaware, Louisiana, Minnesota, Pennsylvania, Rhode Island, West Virginia, and Wyoming, plus these New York counties: Albany, Allegany, Cattaraugus, Chautauqua, Clinton, Columbia, Erie, Essex, Fulton, Genesee, Greene, Montgomery, Niagara, Orleans, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington.

What the letter does not say. It presents the partnership as an opportunity to grow your patient base during Medicare’s Annual Enrollment Period. It says nothing about opting out, and nothing about how the Advantage Plus schedule compares to what you are paid for Aetna Medicare Advantage patients today. Those two silences are the whole PPO consulting question.

 

Which Offices Does the Aetna Partnership Affect?

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The partnership only reaches offices that participate in United Concordia’s National Medicare Advantage Network, and what happens on January 1, 2027 depends entirely on your existing Aetna contracts. Four situations cover almost every office:

Your Current Contracts	What Happens on 1/1/2027	What to Do
In UCCI’s National Medicare Advantage Network, no Aetna contract	Aetna Medicare Advantage patients become in-network at your UCCI Advantage Plus fees	Review your fees with a PPO consulting team before January 1
In UCCI’s network, Aetna direct with Medicare Advantage included	Your Aetna direct contract should continue to govern Aetna Medicare Advantage claims	Confirm with Aetna; no action expected
In UCCI’s network, Aetna direct but you opted out of Aetna Medicare Advantage	Aetna Medicare Advantage can come back in through United Concordia, undoing your opt-out	Get a PPO consulting review before January 1
Not in UCCI’s National Medicare Advantage Network, or in an excluded state or county	Not affected	None

Catching that reversal in advance is routine PPO consulting work. Catching it after January 1 means unwinding claims that already paid at the lower rate.

 

Why Does the Advantage Plus Fee Schedule Matter So Much?

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The Advantage Plus fee schedule matters because the letter confirms Aetna Medicare Advantage patients will be paid on it, not on Aetna PPO fees, and for many offices that schedule sits at the low end of everything they have signed. A default enrollment is about to decide which rate a whole patient population pays you at. Pricing that default is PPO consulting in its simplest form:

• Compare before you decide. Pull your UCCI Advantage Plus fees and set them beside what you collect from Aetna Medicare Advantage patients today, whether out of network or through another arrangement.
• Count the patients. Look at how many Aetna Medicare Advantage patients you actually see. A handful of patients rarely justifies accepting a lower schedule.
• Know when staying in makes sense. If your United Concordia contract is better than average and you are comfortable seeing these patients at those fees, you can let the agreement take effect and do nothing. That is a legitimate outcome, as long as it is a decision and not a default.

Across 2,870+ dental practices, PPO Advisors has seen the same pattern with shared network agreements: the offices that get hurt are not the ones that chose a lower schedule, they are the ones that never knew a choice was being made. PPO consulting exists for exactly this moment, before the effective date, not after the first EOB.

 

How Does This Fit the Bigger Aetna Medicare Advantage Picture?

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The United Concordia partnership arrives as Aetna narrows which shared networks can reach its Medicare Advantage members. Effective the same date, January 1, 2027, Connection Dental providers will no longer participate for Aetna Medicare Advantage dental plans, a change PPO Advisors covered in detail in its Aetna Medicare Advantage and Connection Dental breakdown. Connection Dental participation for Aetna Commercial PPO and PPO II is unchanged.

Those earlier arrangements often carried more workable fees. With them gone, United Concordia becomes a new route into Aetna Medicare Advantage, but for most offices it is a lower-paying one. One door closes, another opens, and the new door pays less.

If you are direct with Aetna, remember how Aetna structures Medicare Advantage. There is no Medicare-only Aetna dental plan. Medicare Advantage access is built into the Aetna PPO direct contract and pays on the same fee schedule, and your direct contract supersedes shared network access for Aetna PPO, which is why the direct contract should continue to govern in most cases. Confirming that is a quick PPO consulting check that prevents a year of misrouted claims.

The backdrop is regulatory as well as commercial. CMS’s 2025 final rule requires Medicare Advantage organizations to submit provider directory data for publication, update it within 30 days of a change, and attest annually to its accuracy. Carriers are reorganizing which networks carry their Medicare Advantage members, and more letters like this one are likely across the industry. Offices with a standing PPO consulting relationship hear about the next one before its effective date, not after.

 

What Should a PPO Consulting Review Settle Before January 1?

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A PPO consulting review of this change should settle three things: what the Advantage Plus schedule does to your Aetna Medicare Advantage collections, whether opting out is right for your office, and what the agreement touches across the rest of your contracts. Offices can generally opt out of shared network agreements like this one, but the letter does not explain how, and the right move depends on your full contract picture.

• Step 1: Confirm you are affected. Check whether your office participates in United Concordia’s National Medicare Advantage Network and whether your state or county is on the exclusion list.
• Step 2: Price the default. Set your Advantage Plus fees against what you collect from Aetna Medicare Advantage patients today, and count how many of those patients you actually see.
• Step 3: Check your Aetna contracts. If you are direct with Aetna, confirm which contract will govern these claims. If you deliberately opted out of Aetna Medicare Advantage, confirm whether this agreement undoes that.
• Step 4: Decide on purpose, then act. Stay in with your numbers in front of you, or opt out before the effective date. Shared network agreements ripple across your whole contract portfolio, so check what each move does to the contracts around it. That portfolio view is what separates PPO consulting from a quick fee lookup.

Because timing and details matter before January 1, PPO Advisors is handling these questions in one-on-one PPO consulting conversations. For most offices, we expect opting out will be the right move. If you received the letter, reach out and our team will review your United Concordia and Aetna contracts with you and walk through your options as part of a full PPO consulting engagement. This is a developing story, and PPO Advisors will update this post on the PPO Advisors blog as United Concordia and Aetna publish more details.

 

The Bottom Line

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• On January 1, 2027, United Concordia’s National Medicare Advantage Network providers become in-network for Aetna Medicare Advantage members, automatically, at their Advantage Plus fees.
• The letter says nothing about opting out and nothing about how the Advantage Plus schedule compares to what you are paid today.
• If you opted out of Aetna Medicare Advantage on your direct contract, this agreement can quietly undo that opt-out at a lower fee schedule.
• A PPO consulting review before January 1 settles the decision with your fees and patient counts in front of you, instead of letting a default enrollment settle it.
• For most offices, PPO Advisors expects opting out will be the right move.

 

Frequently Asked Questions About PPO Consulting for the Aetna Change

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Do I have to do anything to be included in the United Concordia Aetna partnership?

No, inclusion in the United Concordia Aetna partnership is automatic for offices participating in United Concordia’s National Medicare Advantage Network. If you do nothing, you are in-network for Aetna Medicare Advantage members on January 1, 2027, paid on your Advantage Plus fee schedule. Action is only required if you want a different outcome, which makes a PPO consulting review before the effective date the deliberate path.

 

Can I opt out of the United Concordia Aetna Medicare Advantage agreement?

Yes, offices can generally opt out of shared network agreements like the United Concordia Aetna arrangement, but the letter does not explain how. The right path depends on your Advantage Plus fees, your Aetna contracts, and your patient counts, which is why the opt-out belongs inside a PPO consulting review rather than a quick phone call to the carrier.

 

What fee schedule will Aetna Medicare Advantage patients be paid on through United Concordia?

Aetna Medicare Advantage patients seen through this partnership will be paid on your current United Concordia Advantage Plus Maximum Allowable Charge Schedule, not on Aetna PPO fees. For many offices the Advantage Plus schedule sits at the low end of their contracted fees, which is why comparing it to what you collect today is the first step of any PPO consulting review of this letter.

 

I opted out of Aetna Medicare Advantage on my direct Aetna contract. Does this letter affect me?

Yes, if your office participates in United Concordia’s National Medicare Advantage Network, the new partnership can bring Aetna Medicare Advantage patients back in through United Concordia, undoing the opt-out you made on your direct contract. Those claims would pay on the Advantage Plus schedule, so put both contracts in front of a PPO consulting team before January 1, 2027.

 

Sources: United Concordia provider letter, “NEW Partnership with Aetna,” effective January 1, 2027, reviewed by PPO Advisors. GEHA Connection Dental provider communication dated September 1, 2026, regarding Aetna Medicare Advantage participation. Aetna confirmation to PPO Advisors, September 2026, regarding Medicare Advantage access under the Aetna PPO direct contract. Nothing here is legal advice.

 

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✍️ Shelley DeGroff
Founder, PPO Advisors