Aetna Dental and Vision Insurance Plans and Services Overview

Aetna offers a range of dental insurance plans to suit different needs and budgets. These plans include Aetna Dental Access, Aetna Dental Premier, and Aetna Dental Direct.

Aetna Dental Access is available to individuals and families, and it offers coverage for routine cleanings, fillings, and other basic dental services. Annual maximums range from $1,000 to $2,000.

Aetna Dental Premier is a more comprehensive plan that covers major services like crowns, bridges, and root canals. It also offers higher annual maximums, up to $2,500.

Aetna Dental Direct is a low-cost plan that's ideal for those who only need basic coverage. It offers lower premiums, but also lower annual maximums, up to $1,000.

Aetna offers additional benefits with their Medicare Advantage plans, including dental coverage. This coverage may include teeth cleaning, scaling, and polishing, examinations, simple extractions, fillings, dentures or bite adjustments, and radiography (X-rays).

The specific details of each plan vary, and some plans are more comprehensive than others. People can check their plan's Evidence of Coverage for the details of dental coverage.

Aetna's Medicare Advantage plans with dental coverage may have the plan's monthly premium cover the cost of these services. In other cases, a person may need to purchase an optional supplemental benefit and pay an additional monthly premium.

Aetna also offers a stand-alone dental direct plan, which offers preventive care with zero out-of-pocket costs.

Here are some examples of dental services that may be covered under Aetna's Medicare Advantage plans:

Aetna dental insurance is an essential part of the company's comprehensive health plans. Aetna began in 1853 in Hartford, CT, and currently serves the health needs of about 39 million people.

Aetna offers dental insurance plans as part of its overall health insurance offerings. CVS Health acquired the company in 2018.

Aetna's dental insurance plans cover a range of services, including routine cleanings, fillings, and extractions. The company's dental plans are designed to provide affordable and convenient access to dental care.

Aetna's dental insurance plans are available as part of its overall health insurance plans. Each year, the Centers for Medicare & Medicaid Services (CMS) rate Medicare Advantage plans using a star rating system, but Aetna's dental plans are not explicitly mentioned in this context.

Aetna's dental insurance plans are designed to provide peace of mind and financial protection for individuals and families. Aetna's 2021 plans were awarded an average of 4.5 out of 5.0 stars by the CMS, but this rating is for their Medicare Advantage plans, not specifically for their dental plans.

Aetna Advantage plans provide dental benefits through either the Aetna network or direct member reimbursement (DMR). This means you have options for accessing care.

You can use Aetna's online tool to find providers that accept your Advantage plan. This can save you time and hassle when searching for a dentist.

Many Aetna MA plans cover an annual vision exam at no additional cost. This is a great perk, especially if you're due for a check-up.

Benefits are administered through Aetna's network or direct member reimbursement (DMR). Aetna Advantage plans provide dental benefits through either the Aetna network or DMR.

If you have an Aetna Advantage plan, you can use the online tool to find providers that accept your plan. This tool can help you find in-network dentists who have a contract with Aetna.

Network plans cover the total cost of preventive care, including oral exams, dental cleanings, and radiography. Some Aetna Advantage plans also include extensive services like fillings and extractions.

If your plan has a deductible, you must meet the deductible before your plan covers your eligible dental expenses. After you meet your deductible, you will pay a coinsurance amount at the time of service.

Here's a breakdown of how claims are reimbursed:

Keep in mind that your plan may have a deductible and coinsurance percentage or flat dollar amount. You can submit a claim form for reimbursement or have your dentist submit claims for you.

Purchasing an insurance plan can be done online, making it a convenient option for many people. You can visit the insurance company's website and follow the prompts to enter your ZIP code and personal information.

You'll need to provide some basic details such as your birth date and status regarding insurance coverage. You can also choose to add a dependent to your plan or sign up as an individual.

The next page will show you the plans available in your area with links to learn more about costs and benefits. This is a great opportunity to research and compare different plans to find the one that best suits your needs.

You'll need to enter more information about your address and confirm your state residency and preferred language. This helps the insurance company tailor their services to your specific needs.

After entering your information, you'll be shown your monthly premium and start date for your insurance coverage. You'll also be prompted to enter your payment information.

If you'd rather speak to a customer service representative, you can sign up on the phone. This is a good option if you have questions or need help navigating the online process.

With an Aetna network plan, you'll have access to a network of approved dentists who have a contract with Aetna. This means you'll pay less out of pocket for services like oral exams, dental cleanings, and radiography.

Your plan will cover the total cost of preventive care, including the services mentioned above. Some plans even cover fillings and extractions.

To get reimbursed, you can submit an itemized receipt for Aetna-approved services to the company. Aetna will then reimburse you up to the plan allowance.

Here's a breakdown of the reimbursement process:

If you visit an out-of-network dentist, you'll typically pay the full fee upfront and then submit a claim form for reimbursement. Your plan will cover the "recognized charge" for each service, but any difference between this amount and your dentist's normal fee is not covered.

If you visit a network dentist, you generally pay less out of pocket. This is because network dentists have agreed to offer certain services at a negotiated rate.

You'll need to meet your deductible before your plan covers your eligible dental expenses. This is the dollar amount you must pay for covered expenses in a plan year.

After meeting your deductible, you'll pay a coinsurance amount at the time of service. This is a percentage of covered expenses, and the specific amount can be found in your plan documents.

Your dentist may submit your claims for you, making the reimbursement process easier.

If you visit an out-of-network dentist, you'll be billed their normal fee for procedures. Your plan provides benefits using amounts set as the "recognized charge" for each service in your geographic area.

Here are the key steps to follow for out-of-network reimbursement:

Note that if you're enrolled in a PPO Max plan, your out-of-network benefits will be based on the standard rates for network dentists in that geographic area.

If you have an Aetna network plan, you'll need to use an approved dentist from their named network who has a contract with Aetna.

The good news is that in-network plans cover the total cost of preventive care, which includes oral exams, dental cleanings, and radiography.

This means you won't have to worry about paying out-of-pocket for these essential services.

Some Aetna Advantage plans even go beyond preventive care, including extensive services like fillings and extractions.

Here are some examples of what's covered under preventive care:

Replacing missing teeth can be a bit tricky, especially if you're relying on your insurance plan to cover the costs. If the teeth were lost or extracted before your coverage began, then services to replace them may not be covered by your plan.

This applies to first-time dentures, which can be a significant expense. For more details, contact Member Services or review your plan documents.

If you're considering a fixed or removable bridge, you might be out of luck if the teeth that need to be replaced were lost or extracted before your coverage started. Implants are also subject to this rule, which can be disappointing if you've been looking forward to this type of dental work.

Reviewing your plan documents is a good idea to understand exactly what is and isn't covered. You can also contact Member Services to get a clearer picture of your options.

Aetna Dental plans are provided by Aetna Life Insurance Company, part of CVS Health, and keep it simple with three traditional dental PPO plans and a discount card option. You don't need to select a primary caregiver and don't need referrals to see specialists.

To keep your out-of-pocket costs low, choose dental professionals from Aetna Dental's network of providers. You can get a Summary of Benefits from the employer that is providing your insurance, which describes the services that are covered under your plan.

Aetna Medicare Advantage plans offer additional benefits that Original Medicare does not provide, including coverage for dental care such as teeth cleaning, scaling, and polishing, examinations, simple extractions, fillings, and more. The specific details of each plan vary, and some plans are more comprehensive than others.

Here's a list of some of the dental services that may be covered by an Aetna Medicare Advantage plan:

In some cases, a person may need to purchase an optional supplemental benefit and pay an additional monthly premium for dental benefits.

Aetna's five-tier plan search can be a bit complex, but it's worth understanding how it works. Each main plan type has more than one subtype, and some subtypes have five tiers of coverage.

To use the five-tier plan search, you'll need to select the specific subtype of your plan, which may have five tiers of coverage. This search 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.

Keep in mind that your member's benefit plan determines coverage, and some plans may exclude coverage for services or supplies that Aetna considers medically necessary. This means that even if a service or supply is medically necessary, it may not be covered under your plan.

Aetna offers a range of coverage options to suit different needs and budgets. You can choose from three traditional dental PPO plans and a discount card option.

One of the benefits of Aetna's dental plans is that you don't need to select a primary caregiver or get referrals to see specialists. This makes it easy to get the care you need without any hassle.

Aetna's dental plans also offer flexibility in terms of out-of-pocket costs. To keep your costs low, choose dental professionals from Aetna's network of providers.

If you're eligible for Medicare Part A and Part B, you might be eligible for one of Aetna's Medicare Advantage plans with prescription drug and dental coverage.

Here are some examples of dental services that may be covered by Aetna's Medicare Advantage plans:

Keep in mind that the specific details of each plan vary, so it's essential to check your plan's Evidence of Coverage for the details of dental coverage.

Aetna's Medicare Advantage plans are rated four or more stars by the Centers for Medicare & Medicaid Services (CMS) annual Medicare Part C and Part D Performance Data report. This indicates a high level of quality in their health and drug services.

If you're looking for a Medicare Advantage plan with dental coverage, you can search Aetna's website for plans in your area by entering your ZIP code into the search box.

Aetna Dental plans cover a range of services, including composite fillings, which are also known as white fillings. Some plans may limit the benefit to certain teeth.

You can find out which services are covered under your plan by getting a Summary of Benefits from your employer. This document describes the services that are covered.

Composite fillings, also known as white fillings, are covered by Aetna Dental plans, but some plans may limit the benefit to certain teeth. Contact Member Services if you have questions.

Aetna Medicare Advantage plans offer additional benefits that Original Medicare does not provide, including coverage for dental care. Here are some of the services that may be covered:

Keep in mind that the specific details of each plan vary, and some plans are more comprehensive than others.

Aetna offers Medicare Advantage plans with dental coverage, which can be a game-changer for seniors who need regular dental care.

These plans often include additional benefits not covered by Original Medicare, such as teeth cleaning, scaling, and polishing, examinations, and simple extractions. The specific details of each plan vary, but some plans may cover dentures or bite adjustments, radiography (X-rays), and advice on oral hygiene and diet.

Aetna's Medicare Advantage plans with dental coverage can be a cost-effective option for seniors, with some plans offering zero out-of-pocket costs for preventive care. However, the monthly premium may cover the cost of these services, or you may need to purchase an optional supplemental benefit and pay an additional monthly premium.

Here are some examples of Aetna Medicare Advantage plans with dental coverage:

Keep in mind that costs and coverage details can vary depending on your age, location, and provider, so be sure to check your plan's Evidence of Coverage for the details of dental coverage.

You can get a 30-day supply of medication during the initial coverage phase without worrying about out-of-pocket costs.

Some Medicare plans, like Aetna Medicare Assure Plus HMO, offer comprehensive coverage with a maximum out-of-pocket cost of $3,850.

You can expect to pay a monthly premium for plans like Aetna Medicare Assure Plus HMO, with prices ranging from $0 to $37.70 per month.

Aetna Medicare Assure Plus HMO has a $0 deductible, making it a great option for those who want to avoid upfront costs.

Here are some of the benefits you can expect with Aetna Medicare Assure Plus HMO:

Medicare Advantage Plans offer additional benefits that Original Medicare doesn't provide, including dental care, vision care, and mental health services.

Some Medicare Advantage plans, like Aetna's Medicare Advantage plans, provide dental benefits, including coverage for teeth cleaning, scaling, and polishing, examinations, simple extractions, fillings, dentures or bite adjustments, radiography (X-rays), and advice on oral hygiene and diet.

The specific details of each plan vary, and some plans are more comprehensive than others. People can check their plan's Evidence of Coverage for the details of dental coverage.

Aetna Medicare Advantage plans with prescription drug and dental coverage are available to eligible beneficiaries who are signed up for Medicare Part A and Medicare Part B.

These plans can be a good option for seniors who need dental care, as they can help reduce out-of-pocket costs. In fact, Aetna noted in a 2023 press release that 87 percent of their Medicare Advantage plan subscribers are enrolled in plans rated four or more stars by the Centers for Medicare & Medicaid Services (CMS) annual Medicare Part C and Part D Performance Data report.

Here are some examples of Aetna's Medicare Advantage plans with dental coverage:

It's worth noting that Medicare Advantage plans can have varying levels of coverage, and some plans may require a referral to see a specialist. It's essential to carefully review the plan's details and Evidence of Coverage to understand what's covered and what's not.

If you're considering a Medicare Advantage plan with dental coverage, be sure to check the plan's star rating and customer satisfaction ratings to ensure you're getting a high-quality plan.

As a senior, it's essential to understand the costs associated with dental plans. Aetna Dental Plans for Seniors, for instance, vary depending on age and location.

The monthly premium for Aetna Dental plans can range from $21.20 to $44.11 for a 60-year-old woman or a 65-year-old man in Florida.

Preventive care is covered at $0 for all three plans, which is a great perk.

Basic procedures, like fillings and extractions, are covered at 20% and 50% respectively for some plans, but not covered at all for others.

Major procedures, such as root canals and bridges, are covered at 50% for some plans, but not covered at all for others.

A benefits cap of $1,250 and $1,000 applies to some plans, while others have no coverage cap.

Deductibles range from $0 to $50 for some plans, while others have no deductible at all.

Here's a breakdown of the costs for each plan:

Preventive care is a crucial aspect of maintaining good oral health. Regular checkups and cleanings can help prevent many dental issues.

Aetna offers a Preventive PPO plan that provides exams, full-mouth X-rays, and cleanings at no cost. This plan is a good option for seniors on a budget who don't foresee major dental expenses in the near future.

However, it's essential to note that this plan doesn't cover basic procedures or major dental work. If you're able to cover major dental expenditures, this plan might be a good fit for you.

You can also use this plan to get discounts at CVS stores with the ExtraCare Plus program. Just keep in mind that this program isn't available in certain states, including Georgia, Louisiana, Minnesota, Missouri, New York, New Jersey, Oklahoma, Texas, and Virginia.

By prioritizing preventive care, you can avoid more costly and complex dental issues down the line. Regular dental checkups can also help you catch any potential problems early on.

Maintaining healthy teeth is crucial for eating a well-balanced diet. This is because you have difficulty chewing certain high-fiber foods like fruits and vegetables if you have extensive tooth loss.

Untreated gum disease is linked to other health conditions, such as poor overall health. Regular dental checkups can prevent many of these issues or provide treatment for them.

Tooth loss can impact a person's ability to speak and lead to social isolation. Regular dental care can help prevent these issues.

Maintaining good oral hygiene is essential for preventing many dental problems. Regularly seeing a dentist can help you catch any issues early on.

Older adults with poor oral health are more likely to be underweight or obese. This is because they have difficulty eating nutritious foods due to tooth loss.

Preventive dental coverage, including annual exams, cleanings, X-rays, and fillings, is often offered by Medicare Advantage plans. This can help you maintain good oral health and prevent costly dental problems.

If you're on a budget, you might want to consider Aetna's Direct Preventive PPO plan. This plan provides preventive care only, but it's a great option if you don't foresee major dental expenses in the near future.

You'll get exams, full-mouth X-rays, and cleanings at no cost, with no deductible to pay before you can receive preventive dental care. This plan is a good choice if you're able to cover major dental expenditures that might come up.

The Direct Preventive PPO plan also makes you eligible for discounts at CVS stores with the ExtraCare Plus program, which can be a nice perk. However, keep in mind that ExtraCare Plus is not available in some states.

Here's a quick rundown of what you can expect from this plan:

Aetna dental and vision insurance has a precertification process in place to ensure that certain services are covered. This process typically requires prior approval from Aetna before receiving treatment.

Some services, such as dental implants, may require precertification to be covered under the plan. Aetna has a list of covered services that can be found in their member handbook.

Aetna also maintains lists of participating providers, including dentists and eye care professionals. These lists can be found on the Aetna website.

Precertification can be completed online or over the phone, and it's recommended to check with Aetna to see if precertification is required for a specific service.