General anesthesia and intravenous sedation, unless specifically covered and only when done in connection with another eligible dental service When you see a dental care provider for services, you pay up front and get a receipt that includes a description of the services provided. 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. 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. Your out of pocket expenses will be higher if you do not see an in-network provider and, in some plans, benefits may not be available at all for out-of-network providers. Click the Register button to get started. When you have an Aetna Dental plan, you know youre taking the right steps toward being healthy. This information is neither an offer of coverage nor medical advice. For prescribed drugs, pre-treatments or analgesia. 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). *Acupuncture is an essential health benefit, and the discount for this service may duplicate benefits if you are enrolled in a full-service plan. Unlisted, unspecified and nonspecific codes should be avoided. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. Members should discuss any matters related to their coverage or condition with their treating provider. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. So your share of the cost is usually lower. Sachi Fujimoriis a writer and editor based in Brooklyn who focuses on writing about science and health. Pros. The maximum deductible for 2022 is $480, but this plan (Aetna Medicare Choice Plan (PPO)) has a $200. Get discounts on oral health care products like Z Sonic toothbrushes, replacement brush heads and various oral health care kits. 4. . No fee schedules, basic unit, relative values or related listings are included in CPT. PDF Summary of Dental Benefits and Coverage Disclosure Matrix (SDBC) Part I Check with your plan for more details. 2022 Aetna Dental 2 Enroll at www.BENEFEDS.com . Welcome Federal Employees | 2022 Plan Brochures - Aetna Feds Visit the secure website, available through www.aetna.com, for more information. All Rights Reserved. Aetna makes no payment to the third parties you are responsible for the full cost. Aetna 2022 Medicare plans feature more benefits, lower member costs and ** Out-of-network benefits are paid based on recognized charge levels, as determined by Aetna and specified in your plan documents. 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 Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. Each main plan type has more than one subtype. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. And you dont have to have Aetna medical or other coverage with us to purchase. California license number: OB84599. 2022 . No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. CPT only copyright 2015 American Medical Association. So, your share of the cost is usually lower. Once youre a member, you have two ways to engage with your plan online. Most plans also have a benefit maximum, a limit on the amount the plan will pay out to cover dental services. THIS IS A SUMMARY ONLY AND DOES Provided by an out-of-network provider in excess of the recognized charge. Overall, it is very affordable compared to competitors and comes with many different amounts of coverage. You may also have to file your own claims. Links to various non-Aetna sites are provided for your convenience only. All services deemed "never effective" are excluded from coverage. Member Services: 1-877-238-6200 Applicable FARS/DFARS apply. 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. 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. . Once youre a member, heres how you can connect: 1. For more details see our Privacy Policy. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Knowing more about your plan can help you get the most from your benefits and covered services. Aetna 2023 Medicare plans put money back in members' pockets 151 Farmington Avenue, Hartford, CT 06156. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Aetna Inc. and itsitsaffiliated 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. Aetna Medicare dental plans: Coverage, eligibility, and costs Important Disclaimers for Medicare Members For questions on your dental benefits, call us 1-866-409-0937 (TTY: 711). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Dental implants, false teeth, prosthetic restoration of dental implants, plates, dentures, braces, mouth guards, and other devices to protect, replace or reposition teeth and removal of implants 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. Premium deductions will start with the first full pay period 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. 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. Selection of a program provider is also the responsibility of the participant and is not based on any representations by Aetna. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. You can choose from thousands of dental providers nationwide, including those who offer virtual dental visits. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Im turning 65 or just starting to explore Medicare. Aetna Dental has over 60 years of experience offering dental benefits. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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 you'll save more if you stay in network Annual Deductible $50 Per Person $150 Per Family, per calendar year You may pay more when you get care from dentists who arent in the network.**. Student health insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Certain preventive care services are covered at little-to-no-extra cost 2 when . Section 5 Dental Services and Supplies Class A Basic 16 . Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. When billing, you must use the most appropriate code as of the effective date of the submission. 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. 5 Visit AetnaMedicare.com to learn more about the 2022 Aetna Medicare plans. Out of network: And withAetna MA plans, you have a variety of options to make it more affordable and easierto keep up withyourdental care. Medicare Advantage PPO Plans | Aetna Medicare The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Rates start at $7.99 a month. In case of a conflict between your plan documents and this information, the plan documents will govern. Treating providers are solely responsible for medical advice and treatment of members. - The tooth is an abutment to a covered partial denture or fixed bridge. Actual costs and savings may vary by provider, service and geographic location. Preventive services such as cleanings, oral exams and X-rays are covered at 100 percent on most plans. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. Links to various non-Aetna sites are provided for your convenience only. License to use 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. However, if you do this, you wont benefit from negotiated rates. In excess of the benefit, dollar, day, visit, or supply limits stated in your schedule of benefits. 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). Services and supplies provided where there is no evidence of pathology, dysfunction or disease, other than covered preventive services The Aetna Dental Direct plan covers preventative care 100% with no out of pocket cost. 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. Dental plans are all different. . 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 Direct | Secure Member Portal Login Secure Member Portal * required Username * Forgot Username? PDF Dental Benefits Summary - Aetna Aetna Dental Insurance Review: One Of The Best In 2023 - Seniors Mutual 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). ZIP CODE View 2023 plans Learn about these benefits Dental, eyewear and hearing coverage is available. The amount of the discounts will vary depending on the provider and type of service or supply received. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. 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. Alternate Treatment Rule Treating providers are solely responsible for medical advice and treatment of members. Treating providers are solely responsible for medical advice and treatment of members. Aetna Dental Coverage | New York State Nurses Association Home Aetna Dental Coverage For more information on NYSNA dental benefits, offered through Aetna, please refer to the following documents ( .pdf; Adobe Acrobat Reader required): Aetna Navigator Website Introduction Aetna PPO Overview Dental Benefits Summary (NYSNA Full-time RNs) 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. 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. View your plan - Verizon - Aetna Medicare Advantage Print and fill out the reimbursement form. Aetna Dental PPO 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. Aetna Dental has over 50 years of experience offering dental benefits. With Aetna Dental Direct, youll get the coverage you need to keep your teeth healthy. *Actual costs and savings vary by provider and geographic area. Aetna Dental Direct insurance plan is offered by Aetna Life Insurance Company (Aetna). This Agreement will terminate upon notice if you violate its terms. For language services, please call the number on your member ID card and request an operator. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Your Payer Express log in may be different from your Aetna secure member site log in. *Based on January 2023 Aetna provider data There are no claims or referrals to worry about, and no limits on how much you can save. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Some plans cover comprehensive services. Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825, is the Discount Medical Plan Organization. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. New and revised codes are added to the CPBs as they are updated. 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. Network dentists offer special rates for covered services. Very low rates. 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. Original Medicare, on the other hand, does not coverroutinedental care, such as cleanings, X-rays,andfillings. Treating providers are solely responsible for medical advice and treatment of members. Premium deductions will start with the first full pay period That are provided by a family member. 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. AetnaDentalOffers.com is brought to you by DentalPlans.com. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. This Agreement will terminate upon notice if you violate its terms. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Get savings on weight-loss programs and meal plans, and enjoy one-on-one help, personalized menus, online tools and chat rooms. It may be different from your Aetna secure member site log in. Aetna Dental Insurance Plans for Seniors in 2023 - The Senior List Enrollment in this voluntary dental plan is open to all registered students and their eligible dependents. are covered at 100% on most plans. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. For work-related conditions. How is coverage handled overseas? 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. We've broken down the differences between our DMO dental benefits and insurance plan and our PPO dental insurance plans to help you decide. 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. Studies show that a healthy mouth helps you avoid health problems in the body, too. Visit a dentist in the Aetna Dental PPO* network. Youre given an annual allowance to spend on dental care. 1According to the Aetna Enterprise Provider Database as of May 1, 2018. This means you pay nothing out of pocket if you stay in network. CPT only copyright 2015 American Medical Association. Get lower rates when you go to a dentist thats in your PPO network. Aetna does not endorse any vendors, products or services associated with this program. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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 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.