If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. There also may be age and frequency limits on some services. Send the form with the receipt to the claims address found on your member ID card. By texting 90156, you consent to receive a one-time marketing automated text message from Aetna with a link to download the Aetna Health app. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. The information you will be accessing is provided by another organization or vendor. Treating providers are solely responsible for medical advice and treatment of members. ZIP CODE View 2023 plans Learn about these benefits Dental, eyewear and hearing coverage is available. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. The employee pays the remainder through payroll deduction Premiums are deducted on a pre-tax basis Contact Information at Aetna Customer Service 1-877-238-6200 or www.aetna.com About the Plan Aetna Dental Summary - Effective January 1, 2023 Once youre a member, heres how you can connect: 1. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. This information is neither an offer of coverage nor medical advice. These dental benefits follow the same structure as network plans and may require you to choose a dental provider within your network. Verizon - Aetna Medicare Advantage are covered at 100% on most plans. Some subtypes have five tiers of coverage. Aetna makes no payment to the third parties you are responsible for the full cost. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). California license number: OB84599. Sign up at BeneFeds.com or call 1-877-888-3337. The Aetna HealthSM app and your Aetna member website are personalized, seamless and easy to use. As of April 4, 2022, Medicare covers up to eight over-the-counter COVID-19 tests each month, at no extra cost to you if you have . Coverage for the first installation of removable dentures; fixed bridgework and other prosthetic services is subject to the requirements that such removable dentures, fixed bridgework and other prosthetic services are: needed to replace one or more natural teeth that were removed while this policy was in force for the covered person; and are not abutments to a partial denture; removable bridge; or fixed bridge installed during the prior 8 years. You are now being directed to the CVS Health site. While most dental plans require a waiting period for major services like crowns or root canals, if you switch from your existing comparable plan to an Aetna plan, we will waive the waiting period. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. All services deemed "never effective" are excluded from coverage. Aetna 2022 Medicare plans feature more benefits, lower member costs and Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Voluntary Dental and Vision Plans | Columbia Health Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Premium deductions will start with the first full pay period Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. CPT is a registered trademark of the American Medical Association. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). Language services can be provided by calling the number on your member ID card. Links to various non-Aetna sites are provided for your convenience only. Please log in to your secure account to get what you need. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. It's generally known as the Evidence of Coverage (EOC). And one of the main perks of joiningaMedicare Advantage (MA)planis that many plans offer dental coverage to helpyoukeep upwithyour oral health. Dental benefits and dental insurance plans contain exclusions and limitations. Note not all plans and offers available in all markets. Tooth Missing But Not Replaced Rule Reprinted with permission. Taking care of your teeth is as an important part of taking care of your health. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Aetna Dental PPO Get a discount on blood pressure montiors, pedometers, activity trackers, pain relief devices and other Omron products. Compare our plans and find the coverage that's best for you. Instruction for diet, plaque control and oral hygiene . Aetna Student HealthSM is the brand name for products and services provided by Aetna Life Insurance Company, Aetna Health and Life Insurance Company and their affiliated companies. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. Each main plan type has more than one subtype. Visit any licensed dentist outside the network. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. What does the Aetna Dental PPO Plan cover? Each main plan type has more than one subtype. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Yes, I'm a memberNo, I'm looking for a plan. Pay less for acupuncture,* chiropractic visits, therapeutic massage and nutrition services** and for products like wearable fitness devices and fitness kits. Use order code 123AET200. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Links to various non-Aetna sites are provided for your convenience only. Aetna Dental Insurance Plans for Seniors in 2023 - The Senior List Get lower rates when you go to a dentist thats in your PPO network. - The tooth is an abutment to a covered partial denture or fixed bridge. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Click here to review plans with a $0 deductible. Once youre a member, you have two ways to engage with your plan online. The replacement of; addition to; or modification of: existing dentures; crowns; casts or processed restorations; removable denture; fixed bridgework; or other prosthetic services is covered only if specific criteria are met. Be sure to make copies of all of your paperwork. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Links to various non-Aetna sites are provided for your convenience only. That are provided by a family member. Get the coverage you need to keep your mouth, teeth and gums healthy. 2023 DentalPlans.com, Inc. All Rights Reserved. Brushing, flossing and getting regular dental checkups help to keep your mouth healthy. Dual Enrollment If you sign up for a dental and/or vision plan during the 2022 Open Season, your coverage will begin on January 1, 2023. Does your dental plan have a missing tooth clause? Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Acupuncture, acupressure and acupuncture therapy Aetna Dental provides national network coverage for Prince George's County Government through two networks: You receive greater benefit coverage when you use a provider who participates in the Aetna Dental participating network. It may be different from your Aetna secure member site log in. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Dental plans are all different. Visit your PCD: If you see someone other than your selected PCD, you could end up paying more. Visit a dentist in the Aetna Dental PPO* network. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Cigna DPPO networks offer convenient access to quality dentists all across the country and savings on covered dental services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If your plan doesnt include dental coverage, or you want to increase your coverage, you may have the option to purchase dental benefits with an additional monthly premium (coverage varies by plan). CPT is a registered trademark of the American Medical Association. That would not be made if you did not have coverage. Coinsurance: the percentage of dental care expenses you pay after your deductible. We make dental care convenient. Aetna Health members, log-in securely to your account to access all of your health and benefits information, or get your user name and/or password if you've forgotten it. All services deemed "never effective" are excluded from coverage. Why choose ${company} Medicare Solutions? If you enroll in an Aetna Medicare Advantage plan that includes dental coverage, some of the services that may be covered include: Teeth cleaning, scaling and polishing Office visits for oral examinations Non-surgical extractions Fillings Minor denture adjustments X-rays Oral hygiene instruction Dietary advice and counseling Minor bite adjustments As you age, maintaining your oral health is an important part of your whole-body wellness. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". All three plans are available in all 50 states and D.C and feature increased formulary coverage from 2022. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. New and revised codes are added to the CPBs as they are updated. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Register to watch this video opens in a new tab to get answers to frequently asked questions about the Verizon Advantage plan. Includes PPO, HMO, HMO-POS medical plans with or without drugs. If you do not intend to leave our site, close this message. Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met. Members must enroll in this option when they enroll in their plan, or within 30 days of their plans start date. That are experimental or investigational. Aetna 2023 Medicare plans put money back in members' pockets Your InstaMed log in may be different from your Caremark.com secure member site log in. SBBC now offers the option of four dental plans available from three dental carriers. Visit any licensed dentist outside the network. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Covered family members can choose their own PCDs. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Aetna Dental Insurance Review: One Of The Best In 2023 - Seniors Mutual Benefits / Dental - browardschools.com Replacement of a device or appliance that is lost, missing or stolen, and for the replacement of appliances that have been damaged due to abuse, misuse or neglect and for an extra set of dentures Network dentists offer special rates for covered services. The Aetna Dental Direct plan covers preventative care 100% with no out of pocket cost. CPT is a registered trademark of the American Medical Association. Aetna Dental plans come with special perks and discounts, including exclusive offers from CVS Health. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. This is only a summary of the plan's exclusions and limitations. Aetna Inc. and itsaffiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Some preferred provider organization (PPO) and health maintenance organization point-of-service (HMO-POS) plans, however, do allow you to see any licensed dental provider, but you may save money by seeing a provider in our network. Check your Evidence of Coverage (EOC) for more details. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Dental Coverage Through Work for Employees from Aetna | DMO & PPO Plans Preventive services Waiting period*: None, Basic services are covered at 80% with in-network providers (after deductible), Major services are covered at 50% with in-network providers (after deductible), Waiting periods for basic and major care waived with prior dental insurance, No waiting periods for preventive services, See any dentist, but youll save more if you stay in network, 100% coverage for preventive services when you see an in-network dentist, Basic services covered at 80% with in-network providers (after deductible), Major services covered at 50% with in-network providers (after deductible), Waiting periods* for Basic and Major services waived with prior dental insurance, $50 individual / $150 family per calendar year, Waiting period is waived if all family members enrolling had dental coverage within the past 90 days. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Dental benefits are already included inthe majority ofAetna MA plans. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Dental care is a vital part of maintaining yourhealth and well-being, especially as you age. Visit the secure website, available through www.aetna.com, for more information. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. With Aetna MA plans that include a direct member reimbursement (DMR) allowance, members are given a set amount of money to spend each year on dental care. Find your dentist now in Aetna's large nationwide network. 2022 Aetna Dental 2 Enroll at www.BENEFEDS.com . This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Password * Forgot Password? The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement. Accessibility Services:If you are a person with a disability who needs assistance using our websites, our Customer Service Representatives can assist you. Aetna MAplans offer three types of dental benefits:network,direct memberreimbursementallowanceand optional supplemental benefits. With our dental insurance plans for individuals, you can get services from either a participating or nonparticipating dentist. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Go to the American Medical Association Web site. Massachusetts license number: 10041444. That are not medically necessary. PLAN EXCLUSIONS AND LIMITATIONS* Dental services and supplies made with high noble metals (gold or titanium) except as covered in the Eligible Dental Services section of your insurance policy The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. 2022 - 2023 Aetna PPO Dental Plan Design and Benefits Summary Visit any licensed dentist - in or out of network In network: Visit a dentist in the Aetna Dental PPO* network. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna Dental PPO Plan More reasons to smile Worldwide dental coverage and plans with no deductible New Hires have 60 days to choose benefits. General anesthesia and intravenous sedation, unless specifically covered and only when done in connection with another eligible dental service But your plan features and costs will vary depending on the plan you choose. If you are already an Aetna Dental Insurance Member and have a question regarding your existing policy or claim, please visit Aetna.com or call 1-800-872-3862 I have a question about billing Topic* Please select a topic for your inquiry Billing Question Other Network dentists offer special rates for covered services. For comprehensive services, such as fillings, extractions and crowns, the coverage varies according to plan, and you may have to pay a portion of the cost of services. This Aetna Dental Preferred Provider Organization (PPO) benefits summary is provided by Aetna Life Insurance Company for some of the more frequently performed dental procedures. And you dont have to have Aetna medical or other coverage with us to purchase. You may also have to file your own claims. To learn more about using your Aetna MA dental benefits, read our guide below. Disclaimer of Warranties and Liabilities. . You can choose from one of the more than 420,000 dentist locations in the Aetna Dental PPO network. You can start using your plan right away! Alternate Treatment Rule In MD and NJ, student medical insurance is underwritten by Aetna Health and Life Insurance Company (AHLIC).Self-insured plans are funded by the applicable school, with claims administration services provided by Aetna Life Insurance Company. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Members should discuss any matters related to their coverage or condition with their treating provider. Caring for your teeth should never feel out of reach with Aetna Dental Direct. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Your dental plan pays the rest. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". A primary care dentist (PCD) helps guide your care with this DMO* plan. It gives members access to discounted fees according to schedules negotiated with providers by Aetna Life Insurance Company for Aetna Vital Savings. Just show your discount card at your appointment and you'll get instant savings 15 percent to 50 percent off the cost of most services*. Aetna Member Log-in Aetna Dental has over 50 years of experience offering dental benefits. Unlisted, unspecified and nonspecific codes should be avoided. Want to see options for a different location? Pricing starts at $20 in most regions, and also includes: No waiting periods Inclusive plans. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. In excess of the benefit, dollar, day, visit, or supply limits stated in your schedule of benefits. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change.
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