aetna dental ppo coverage 2022

If you do not intend to leave Aetna Medicare, close this message. Network dentists offer special rates for covered services. All Rights Reserved. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. When you have an Aetna Dental plan, you know youre taking the right steps toward being healthy. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Disclaimer of Warranties and Liabilities. Members should discuss any matters related to their coverage or condition with their treating provider. Instead, check your benefits summary to find your share of the costs. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. With a PPO plan, you can visit any dentist you want (whether they are in or out of the network) and usually receive some coverage level. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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. Aetna may receive a percentage of the fee you pay to the discount vendor. Since Dental Clinical Policy Bulletins (DCPBs) 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. 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. We're here 8 a.m. - 8 p.m., Monday through Friday. 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. This Agreement will terminate upon notice if you violate its terms. How we make it simple for you About Medicare Advantage We're here to help you learn more about what you can get out of Medicare Advantage. Provider Directory Last Updated: April 22, 2023 Page Last Updated: January 27, 2023 Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Once youre a member, heres how you can connect: 1. Aetna Invisalign Coverage Your Aetna plan might cover your Invisalign treatment, although it depends entirely on the plan. Top 3 reasons to choose Aetna Dental You can also submit paper claims. A Nationwide Dental PPO Plan Who may enroll in this plan: All Federal employees, annuitants, and . Treating providers are solely responsible for medical advice and treatment of members. Cigna DPPO networks offer convenient access to quality dentists all across the country and savings on covered dental services. 2023 DentalPlans.com, Inc. All Rights Reserved. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Vision and hearing at no additional cost. Selection of a program provider is also the responsibility of the participant and is not based on any representations by Aetna. Direct member reimbursement allowance: How to get reimbursed for dental care. Orthodontic treatment except as covered in the Eligible Dental Services section of your insurance policy If your MA plan doesnt include dental coverage, or you want to increase your coverage, you may have the option to purchase dental benefits for an additional monthly premium. CPT only Copyright 2022 American Medical Association. Program providers are solely responsible for the products and services they provide. You get a broad choice of dentists and dental providers, wellness discounts and offers that stretch your health care dollar, digital tools to easily manage your care, and more. Enjoy discounts on hearing aids, exams and hearing aid batteries mailed to your home. It may be different from your Aetna secure member site log in. Allow approximately 4-6 weeks for reimbursement. Insurer Name: Aetna Life Insurance Company Plan Name: Aetna Dental PPO Policy Type: PPO Insurer Phone #: 1-877-238-6200 Effective Date: 01/01/2022-12/31/2022 Insurer Website: www.aetna.com THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND WHAT YOU WILL PAY FORCOVERED SERVICES. 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. 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. Routine dental care can help you have stronger teeth, healthier gums and a brighter smile. For additional language assistance: Espaol | | Ting Vit | | Tagalog | P | | Kreyl | Franais | Polski | Portugus | Italiano | Deutsch | | | Other Languages. Cigna DPPO plan features 1. A primary care dentist (PCD) helps guide your care with this DMO* plan. Check your Evidence of Coverage (EOC) for more details. 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. This site has its own log in. Aetna handles premium payments through InstaMed, a trusted payment service. Original Medicare, on the other hand, does not coverroutinedental care, such as cleanings, X-rays,andfillings. CPT only Copyright 2022 American Medical Association. You may also have to file your own claims. Preferred Provider Organization (PPO) plans. Aetna does not endorse any vendors, products or services associated with this program. 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. 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. With Aetna Dental Direct, you'll get the coverage you need to keep your teeth healthy. Crown, inlays and onlays, and veneers unless for one of the following: Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. Want to learn more about your dental coverage? The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. First installation of a denture or fixed bridge, and any inlay and crown that serves as an abutment to replace congenitally missing teeth or to replace teeth all of which were lost while the person was not covered Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Coinsurance: the percentage of dental care expenses you pay after your deductible. Aetna Medicare Advantage plans provide benefits that original Medicare does not. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. For work-related conditions. Teeth whitening and facings on molar crowns and pontics will always be considered cosmetic. 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 While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Treating providers are solely responsible for medical advice and treatment of members. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The availability of a particular provider cannot be guaranteed and provider network composition is subject to change. Altius Health Plans: HMO (PDF) - UT, ID (Southwest & Eastern), WY (Uinta County) HDHP (PDF) - UT, ID (Southwest & Eastern), WY (Uinta County) For information about our plans available through the Federal Employees Dental and Vision Insurance Program (FEDVIP), please visit our Dental PPO Plan site or our Aetna Vision Preferred plan site. They are not benefits under your insurance plan. 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. Language services can be provided by calling the number on your member ID card. This Agreement will terminate upon notice if you violate its terms. Aetna will continue to offer most Medicare Advantage members access to routine vision, dental and hearing coverage. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Disclaimer of Warranties and Liabilities. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. This benefit maximum can range from about $150 to $6,000. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Dental network Direct Member Reimbursement (DMR) Not sure If you're covered through a former employer, union, trust or other retirement system, then you have a dental network plan and are covered by the Aetna Dental PPO network. In excess of the benefit, dollar, day, visit, or supply limits stated in your schedule of benefits. Give your member information at your visit. All three plans are available in all 50 states and D.C and feature increased formulary coverage from 2022. Links to various non-Aetna sites are provided for your convenience only. You pay up front for dental care and submit receipts for reimbursement. 5 Visit AetnaMedicare.com to learn more about the 2022 Aetna Medicare plans. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. These typically include some level of dental coverage, including twice-yearly oral health exams, teeth. If you need a PDF document in an accessible format, you can request it directly through"Contact Us" here or at the top of the page. 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. If you do not intend to leave the Medicare site, close this message. The member's benefit plan determines coverage. There also may be age and frequency limits on some services. Sign up at BeneFeds.com or call 1-877-888-3337. Dental insurance plans are underwritten by Aetna Life Insurance Company. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Purchasing the Aetna dental discount cards is easy - online, by mail or by phone. The Aetna HealthSM app and your Aetna member website are personalized, seamless and easy to use. Just check with your employer to see which plans are available to you. This material is for information only. . Information is believed to be accurate as of the production date; however, it is subject to change. your coverage will begin on January 1, 2022. Register 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 . Aetna MA plans offer three types of dental coverage: For HMO plans, you must see a dental care provider within the network of approved providers. Links to various non-Aetna sites are provided for your convenience only. You can start using your plan right away! Or log in to your member account to submit the form online. To view the form just select Continue. Member Services: 1-877-238-6200 Provided by an out-of-network provider in excess of the recognized charge. Aetna is continuing to expand the Aetna Dental PPO network across the country to . The three carriers providing service to the District's employees are CompBenefits/Humana (Basic and Enhanced PPO/Indemnity and DHMO Managed Care), Aetna (Basic and Enhanced PPO/Indemnity), and Aetna (Basic and Enhanced DHMO Managed Care). But your plan features and costs will vary depending on the plan you choose. Network dentists also file claims for you. Links to various non-Aetna sites are provided for your convenience only. Instruction for diet, plaque control and oral hygiene Remember Username Secure Login First time here? All services deemed "never effective" are excluded from coverage. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. See dentists both in and out of our network. The information you will be accessing is provided by another organization or vendor. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Register to watch this video opens in a new tab to get answers to frequently asked questions about the Verizon Advantage plan. Dental care, eyewear and hearing aids Many of our Medicare Advantage plans include dental, eyewear and hearing benefits. Dental insurance plans contain exclusions and limitations. 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. For additional language assistance: Choose from more than 120,000 dental providers nationwide, including providers who offer virtual visits through tele-dentistry. 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. Find your dentist now in Aetna's large nationwide network. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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 Please log in to your secure account to get what you need. California license number: OB84599. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. And you dont have to have Aetna medical or other coverage with us to purchase. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. Some subtypes have five tiers of coverage. No claims or paperwork for in-network care. It does not meet the Minimum Creditable Coverage requirements in Massachusetts. See your Evidence of Coverage for details. 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. Since Dental Clinical Policy Bulletins (DCPBs) 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.

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