The Aetna Dental Expense Plan or DEP consists of our Preferred Provider Organization, also referred to as the PPO network of providers with both in- and out-of-network coverage. Aetna Dental PPO helps to cover the cost of dental procedures. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. Two of the most common types of Atena dental insurance are PPO and DHMO plans. 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. Select a state below to update coverage details. If you're wondering whether your plan helps pay for certain services, such as dental care or depression screening, come directly here. Medicaid and the Children's Health Insurance Program (CHIP) Offer Free Or Low-Cost Health Coverage To Children And Families. With our dental insurance plans for individuals, you can get services from either a participating or nonparticipating dentist. Our Select Dental PPO helps you pay for dental care and features plans with no waiting periods for covered services or a copay plan.1 You get the care you need, when you need it. Understanding Medicare Advantage Dental Benefits | Aetna Your plan may provide other materials, like a membership card or a prescription drug benefit card. Does Aetna Medicare Cover Dental? 2021-2022 Coverage Explained Aetna has selected Caremark as the prescription management and mail delivery service for our members. The Aetna Medicare Elite Plan (PPO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $7,550 (MOOP). Stamford Dentist Accepting Aetna PPO Dental Insurance However, despite his best efforts he still has a few unhealthy habits he can’t shake, most notably a weakness for jelly donuts. Your Payer Express log-in may be different from your Aetna secure member site log-in. exclusive provider organization (EPO) or a preferred provider organization (PPO) plan are supported by the Aetna Dental PPO network. Self Only. If you do not intend to leave our site, close this message. Check the Evidence of Coverage (EOC) for more information. 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. You can choose from one of the more than 330,000 dentist locations in the Aetna Dental PPO network. Care Review: Aetna Dental Plans 2022 rates for zip code 60302 (Change zip code) Biweekly Rates. CDHP: Aetna Consumer Directed Health Plan (Open Access) HMO (Aetna Select) Choice POS II (Open Access) Aetna Out-of-Area (OOA) PPO. Self Only. This plan uses the Aetna Dental® PPO Network. 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. Aetna.com 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. Speak with a licensed insurance agent 1-877-890-1409 TTY 711, 24/7 If you do not see a dental network listed, please refer to your Evidence of Coverage (EOC) for more details on what is offered with your plan. Aetna offers two Dental PPO insurance plans to individuals and families, the Aetna Dental Direct Preferred and the Aetna Dental Direct Core. 0000001032 00000 n Self & Family. 0000006681 00000 n To check that your provider participates, visit our website or call us. That was pretty easy. However, if you do this, you won’t benefit from negotiated rates. In-network dentists are independent contractors in private practice. 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 . * In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN). enrolled in the Aetna Dental plan for the entire and continuous 12-month waiting period to receive orthodontic coverage. Aetna Dental ® coverage through work When you have an Aetna Dental plan, you know you're taking the right steps toward being healthy. Aetna Dental DMO Option. Some plans also offer extra benefits, like routine dental or vision care, membership in fitness programs, or bathroom safety devices. The graphic below can help you review important sections. Aetna Traditional Dental (PPO) Plan. With 89,000 providers nationwide, it's easy to find a provider close to home. * In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN). With our Aetna Dental ® PPO insurance plan, participating dentists may offer discounted rates on additional services such . In Texas, the Dental Preferred Provider Organization (PPO ) is known as the Participating The plan offers both network (DMO) or out-of-network (PPO) coverage. The Dental Plan provides coverage for many dental services that you and your eligible dependents may need. Participating dentists have agreed to provide services at a negotiated rate for covered services. Taking care of your teeth is as an important part of taking care of your health. The cost of PPO dental coverage reflects local costs. 100% coverage for preventive services when you see an in-network dentist, Waiting periods waived with proof of prior dental insurance, Basic services covered at 80% with in-network providers (after deductible), Major services covered at 50% with in-network providers (after deductible). We encourage you to check with your participating provider prior If you choose a network dentist, you may save money because our network dentists have agreed to provide care for covered services at special rates. With Aetna Dental Direct, you'll get the coverage you need to keep your teeth healthy. With a PPO, you don't need to choose a primary care doctor and can utilize healthcare providers inside or outside your network (although you'll typically pay less for . If you have a plan that includes prescription drug benefits, this section will direct you to where you can find your plan’s formulary. With Aetna Dental Direct, you’ll get the coverage you need to keep your teeth healthy. **Out-of-network benefits are paid based on recognized charge levels, as determined by Aetna and specified in your plan documents. The EOC is the legal contract between you and the Medicare plan. Aetna Dental PPO. Aetna Medicare PO Box 7762 London, KY 40742. See dentists both in and out of our network. We’re bringing you to our trusted partner to help process your payments. In this section, you can learn whether your plan covers follow-up care and when your plan considers an emergency episode over. You must see a dental care provider within our network of providers. $17.69. COVID-19 Resources. Along with these benefits, Aetna Medicare dental coverage is the same as original Medicare, which includes dental services provided in a hospital, such as after a facial injury or due to oral cancer. View our Privacy Policy. 2022 rates for zip code (Change zip code) Biweekly Rates. El Paso, TX 79998-1282. If your child requires Phase I and Phase II ortho, the second series may not be fully covered. You can choose from one of the more than 330,000 dentist locations in the Aetna Dental PPO network. <]>> As a participating dentist, you'll be able to see all Aetna Dental Medicare Advantage members, with . $17.69. Preventive services - Waiting period*: None, Basic services - Waiting period*: 6 months, Major services - Waiting period*: 12 months, *In Pennsylvania, the "waiting period" is called an "elimination period.". With Aetna Dental Direct, you'll get the coverage you need to keep your teeth healthy. This plan includes additional Medicare prescription drug (Part-D) coverage. You’ll also get your member ID card and a notice that tells you how to get other important documents online or by mail. Aetna Dental PPO? in ZIP Code Orthodontia coverage for all ages, including at-home products. One of the first things you learn when shopping for a Medicare plan is that you have a range of options, especially if you choose a Medicare Advantage plan. • Only cover one round of orthodontic treatment per lifetime. Aetna Dental Direct Core PPO In network, you pay Out of network, you pay Preventive services — Waiting period: none You can track your claims online and even receive e-mail alerts when a claim has been processed. Any change in the plan will result in a new 12 month waiting period. You’ll also find a list of pharmacies that work with your plan. The address for our administrative office is: Aetna Dental Federal Plans PO Box 550 Blue Bell, PA 19422-0550 1-800-537-9384 www.aetnafeds.com 6 This not only gives you a great selection of qualified dentists to choose from, but increases the likelihood that your dentist already participates in the network. Look at you smiling. First, you can look at it anytime without having to worry about where you filed away your hard copy. The dental benefits Plan described in this Booklet is a benefit Plan of the Employer.These benefits are not insured with Aetna but will be paid from the Employer's funds.Aetna will provide certain administrative services under the Aetna dental benefits Plan. Dental services (in addition to Original Medicare coverage) Our plan pays up to $1,000 every year for covered services. 3. Since Box 14597 Lexington, KY 40512-4597. Learn more about our plans for individuals, get a quote, or see available plans in your area. 0000004586 00000 n Before making a decision, please read the plan s applicable federal brochure(s). Box 14094 Lexington, KY 40512-4094. You can see in- or out-of-network providers for dental services. plan terms. 0000006192 00000 n Aetna Dental has over 50 years of experience offering dental benefits. Aetna Dental Review. 2022 Plan Documents. Aetna Dental provides national network coverage for Prince George's County Government through two networks: 2021 Plan Documemts. zip code. The Aetna Medicare Advantra Silver (PPO) has a monthly premium of $14.00 and has an in-network Maximum Out-of-Pocket limit of $5,900 (MOOP). Under this plan, you may choose at the time of service either a PPO participating dentist or any nonparticipating dentist. With the Aetna Dental Direct PPO plans, you may choose at the time of service either a PPO network dentist or any out-of-network dentist. Special promotions including, but not limited to, additional months free are not available Components of Your Medical Plan. When not writing about health he tries to stay healthy through activities like hiking, climbing and paddling in the far flung corners of his native state of California. If you have a Medicare Advantage plan, this section will tell you where you can find a list of doctors who are in your plan’s network. Delta Dental's PPO network is one of the nation's largest, with more than 112,000 dentists participating in over 278,000 locations nationwide. Aetna will be the carrier for the Dental DMO option. 2022 rates for zip code 39701 (Change zip code) Biweekly Rates. Certain Aetna Medicare Advantage plans may offer coverage for dental care like cleanings and fillings. 0000002077 00000 n Want to become a . It’s usually in the same chapter as the cost information shown above. Costs of preventive services like oral exams, routine cleanings and X-rays. 0000000016 00000 n • Have a maximum allowable orthodontic fee that the plan covers, meaning they only pay for braces up to a certain dollar amount - typically $1000 . 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. Aetna handles premium payments through InstaMed, a trusted payment service. Plans Starting from Dental PPO insurance plans are underwritten and/or administered by Aetna Life Insurance Company (Aetna). Learn more about Aetna Medicare plans that may be available in your area. 165 0 obj <> endobj Aetna is well-known for providing medical, dental, prescription and disability insurance, among other financial products. xref If you do not intend to leave our site, close this message. Aetna Medicare Advantra Silver (PPO) H5522-005 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Pennsylvania. there is no paperwork or reimbursement, you must pay for the service at the time Table of Aetna Dental PPO rates. NY Nurse: October 2021. Dental Aetna - Health Insurance Plans Aetna. Aetna Dental offers three dental insurance plans and a dental discount plan, explained later in this review.Aetna Dental covers over 14 million members, and the company also provides Medicare supplement insurance with dental benefits not normally . All 50 states, plus the District of Columbia and Puerto Rico, have been assigned to one of five groups, established by Aetna, based on similar average dental costs for PPO coverage. Aetna Medicare Essential Plan (PPO) H5521-091 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Alabama and Georgia. Most dental insurance plans will…. We have many patients in the office who have Aetna Dental PPO. It’s generally available starting in September and describes costs and benefits of your plan that will take effect on January 1 of the following year. Upcoming Workshops. Members of these plans that choose a provider not in the Aetna Dental® PPO Network may have higher costs. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. The school has chosen a plan that makes it easy to keep your smile. Dental PPO insurance plans are underwritten and/or administered by Aetna Life Insurance Company (Aetna). to California residents or on Fully Insured Plans. Can I find out what my. 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. Discounts on services like gym memberships, massages, weight-loss programs and more. Treating patients . 0000003094 00000 n 0000004067 00000 n It’s a good idea to skim your EOC highlights every year. which coverage is approved, you may have to pay the difference in cost between the approved service and the more costly covered service. This site has its own login. The Aetna Dental DMO option provides benefits for the same services that are covered under the Dental PPO options, but at a significantly lower out-of-pocket cost as long as you use a dentist that participates in the Aetna Dental DMO network. Tip: Printed EOCs can run as long as 200 pages. 1-800-537-9384 www.aetnafeds.com Often, their insurance combines with your employer's health insurance plan. %PDF-1.4 %���� As a participating dentist, you'll be able to see all Aetna Dental Medicare Advantage members, with . 0 0000006929 00000 n Aetna Medicare Explorer PPO: $6,700 out-of-pocket maximum Cigna, on the other hand, offers tiered health insurance coverage with Bronze, Silver, and Gold plans that come with increasing levels of . Aetna Dental PPO. Aetna Dental ® PPO service area in Massachusetts includes Barnstable, Berkshire, Bristol, Essex, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester Counties. Is a Medicare Advantage plan right for you? Self + 1. For about $110 a year, members gain access to discounts between 15% and 50% on a huge range of dental procedures (the specific discounts vary based on the type of procedure). The deductible is a set amount that typically you pay before co-insurance starts. High Option. With Aetna Dental® plans, you get more than ancillary products, you get a menu of plan choices to protect members' whole health, for a whole-healthy business. Self + 1. 165 18 Orthodontic Treatment. This is a brief description of the features of the Aetna Dental PPO plan. Below are some sections included in every EOC, along with quick tips on how to find the important information in each section. Why choose ${company} Medicare Solutions? Members residing outside of the service area seeking in-network level of care would need to seek services within the approved service area. Aetna Columbia Dental Plan: Choose from a broad range of dentists in three categories, including Columbia University College of Dental Medicine faculty and alumni—the "Columbia Preferred Dental Network", or dentists in the national Aetna PPO network. for a list of dentists and other dental providers. You can also fax your form to: 1-859-389-6505. Preventive Plus benefits include: Low deductibles for individuals and families. (Few people sit down and read them cover to cover.) Preventive Plus is PPO dental insurance that offers the kind of quality dental coverage that many people seek. Aetna PPO Plans. **Out-of-network benefits are paid based on recognized charge levels, as determined by Aetna and specified in your plan documents. Legal notices Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). Under this plan, medically necessary treatment for a covered illness or . reimbursements paid according to your contracted Aetna PPO fee schedule. 0000005658 00000 n fees when you pay. ** *Some HMO-POS and PPO members with Total Choice Dental benefits can also see dentists that are not part of the Aetna Dental PPO Network. If you do not intend to leave our site, close this message. PO Box 981282. It helps to know how your plan covers emergency services before you actually need them. This section will tell you what to expect. Speak with a licensed insurance agent 1-877-890-1409 TTY 711, 24/7 It's usually in the same chapter as the cost information shown above. Self & Family. dental procedures. Aetna.com. But no matter which plan you choose, you’ll be able to read a document that provides important details about your plan. All Medicare members can read a document online that outlines the plan features. Under the Dental Preferred Provider Organization (PPO) plan, you may choose at the time of service either a PPO participating dentist or any nonparticipating dentist. Check your 2022 Member ID card. Aetna Dental has over 50 years of experience offering dental benefits. trailer 0000000656 00000 n Mark Pabst has worked as a writer and researcher in the health care field for almost two decades. It can help you decide whether to go to the emergency room, urgent care or walk-in clinic. Aetna plans also set a maximum coverage amount for each plan year that usually falls within $1000 and $1500. See the Aetna Dental online directory at . Most will include the dental PPO network name on the back of the card. 0000005121 00000 n Dental benefi ts are off ered, underwritten and/or administered by Aetna Life Insurance Company (Aetna). 15.02.318.1 2 Summary of Benefits This Aetna Dental® Preferred Provider Organization (PPO) insurance benefits summary is provided by Aetna Life Insurance Company (Aetna) for some of the more frequently performed dental procedures. **Some HMO-POS and PPO members can also see dentists that are not part of the network. $33.91 Per Month The discounts are available through participating healthcare providers Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories. Under the Dental Preferred Provider Organization (PPO) plan, you may choose at the time of service either a PPO participating dentist or any nonparticipating dentist. This plan includes additional Medicare prescription drug (Part-D) coverage. The employer's location will determine its group. You are leaving our Medicare website and going to our non-Medicare website. Coverage may not be available in all states and benefits, rates and riders may vary by state. to beginning treatment. All dental Medicare claims . Their coverage is also available to individuals that do not have coverage through their employment or need a separate policy. Same as network coverage. Link to PDF2021 - 2022 Aetna PPO Dental Plan Design and Benefits Summary. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. companies, including Aetna Life Insurance Company and its affi liates (Aetna). Treating patients . 0000001584 00000 n This plan includes additional Medicare prescription drug (Part-D) coverage. It’s generally known as the Evidence of Coverage (EOC). Texas Members: In Texas, the Preferred Provider Organization (PPO) plan is known as the Participating Dental Network (PDN). Aetna Medicare Select Plan (PPO) H5521-300 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Aetna Medicare available to residents in Nevada. Not every plan offers the same extra benefits, and some plans might not offer any extra benefits.
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