Alternate Treatment Rule We encourage you to check with your participating provider prior to beginning treatment. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. For more info about your no-cost OneTouch BGM for Aetna Medicare plan members, you can visit us online or call 1-877-764-5390 ${tty} without a prescription. What's an Evidence of Coverage (EOC)? | Aetna Medicare Dental Preferred Provider Organization (PPO) FAQs | Aetna Links to various non-Aetna sites are provided for your convenience only. You will receive the discount off the providers usual and customary fees when you pay. You may also have to file your own claims. 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. For which you have no legal obligation to pay. 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. Language services can be provided by calling the number on your member ID card. Cancelled or missed appointment charges or charges to complete claim forms. Enjoy discounts on hearing aids, exams and hearing aid batteries mailed to your home. Find the right plans and programs for you. See dentists both in and out of our network. It's generally known as the Evidence of Coverage (EOC). All Rights Reserved. If you do not intend to leave Aetna Medicare, close this message. Whats covered under Medicare Advantage dental plans. Annual Deductible $50 Per Person $150 Per Family, per calendar year, Annual Maximum Benefit $1,250 per covered person. There is one exception, however:If you needmedicaldental procedures whileyourein the hospital, Medicare may pay for those services as part of Medicare Part A (hospital insurance). THIS IS A SUMMARY ONLY AND DOES Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. First time users can also sign up and register for an account. 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). You should: Review the Electronic Claim Vendor List Electronic Claim Vendor List. Aetna MAplans offer three types of dental benefits:network,direct memberreimbursementallowanceand optional supplemental benefits. General anesthesia and intravenous sedation, unless specifically covered and only when done in connection with another eligible dental service For additional language assistance: Espaol | | Ting Vit | | Tagalog | P | | Kreyl | Franais | Polski | Portugus | Italiano | Deutsch | | | Other Languages. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Language services can be provided by calling the number on your member ID card. Disclaimer of Warranties and Liabilities. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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 be sure to add a 1 before your mobile number, ex: 19876543210, Use our provider search tool to search, in the network, by name, specialty or procedure, See your benefits summary and get information about what's covered, Pull up your ID card whenever you need it. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". We make dental care convenient. With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. 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. Use order code 123AET200. 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). Treating providers are solely responsible for dental advice and treatment of members. 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 The information you will be accessing is provided by another organization or vendor. The member's benefit plan determines coverage. Save on gym memberships, health coaching, fitness gear, wearable fitness devices, group fitness on demand and more. Enrollment in this voluntary dental plan is open to all registered students and their eligible dependents. Please log in to your secure account to get what you need. Aetna Medicare Advantage HMO-POS plans. 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. You also have the flexibility to visit a licensed dentist who does not participate in our network. Special perks and discounts, including exclusive offers from CVS Health, Search for providers in-network by using our. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. The material is for information only. Members should discuss any matters related to their coverage or condition with their treating provider. If you do not intend to leave our site, close this message. Please be sure to add a 1 before your mobile number, ex: 19876543210. This is donethrough an optional supplemental benefit. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. With adirect member reimbursementallowance, youre givena set amount of money to spend each year on dental care.. CPT is a registered trademark of the American Medical Association. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Deductible: the dollar amount some plans require you to pay for services before coverage starts. Choose from leading manufacturers and get free follow-up service for one year. The member's benefit plan determines coverage. Aetna Medicare SM Plan (PPO) Learn more about Aetna Feeling Good: Your Verizon Aetna magazine Check out Feeling good , the magazine created specifically for Verizon Aetna members. Everyone can get their own in-network primary care dentist. Aetna Dental Direct PPO Plans are Subject to the Following Rules: Replacement Rule Dentures, crowns, inlays, onlays, bridges, or other appliances or services used for the purpose of splinting, to alter vertical dimension, to restore occlusion, or correcting attrition, abrasion, or erosion Aetna will continue to offer most Medicare Advantage members access to routine vision, dental and hearing coverage. A good day is one where she eats her vegetables and remembers to live in the moment with her baby girl. Visit any licensed dentist outside the network. your coverage will begin on January 1, 2022. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. You are now being directed to CVS Caremark site. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Instruction for diet, plaque control and oral hygiene 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. You are now being directed to the CVS Health site. Once youre a member, heres how you can connect: 1. 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. If you do not intend to leave the Medicare site, close this message. Applicable FARS/DFARS apply. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Purchasing the Aetna dental discount cards is easy - online, by mail or by phone. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. But your plan features and costs will vary depending on the plan you choose. Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. Aetna makes no payment to the third parties you are responsible for the full cost. For more details see our Privacy Policy. 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 Pennsylvania, the waiting period is called an elimination period and most Basic services have one month waiting period. The availability of a particular provider cannot be guaranteed and provider network composition is subject to change. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. This benefit maximum can range from about $150 to $6,000. Applicable FARS/DFARS apply. *Based on January 2023 Aetna provider data La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Network dentists offer special rates for covered services. Does your dental plan have a missing tooth clause? By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Treating providers are solely responsible for medical advice and treatment of members. Each main plan type has more than one subtype. 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) Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Rates start at $7.99 a month. 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). This Agreement will terminate upon notice if you violate its terms. If youre unable to print out the form, you can write out all the required information on a piece of paper and send it with your receipts. Weve broken down the differences between our DMO dental benefits and insurance plan and our PPO dental insurance plans to help you decide. Find a Medicare Dentist | Aetna Medicare Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). the difference in cost between the approved less costly service and the more costly covered service. 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 Provided by an out-of-network provider in excess of the recognized charge. Orthodontic treatment except as covered in the Eligible Dental Services section of your insurance policy The program does not make any payments to providers. Brushing, flossing and getting regular dental checkups help to keep your mouth healthy. PLAN EXCLUSIONS AND LIMITATIONS* 151 Farmington Avenue, Hartford, CT 06156. You can choose from thousands of dental providers nationwide, including those who offer virtual dental visits. 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. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. 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 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. Best Dental Insurance Plans for Seniors in 2023 - The Senior List AetnaDentalOffers.com is brought to you by DentalPlans.com. 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. Si tu intencin no era salir del sitio web, cierra este mensaje. That are not medically necessary. And you dont have to have Aetna medical or other coverage with us to purchase. Unlisted, unspecified and nonspecific codes should be avoided. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. 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. Aetna Dental PPO Plan More reasons to smile Worldwide dental coverage and plans with no deductible New Hires have 60 days to choose benefits. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Shop around different dental care providers in your area to compare costs and make the best use of your annual allowance. Check your plan's Evidence of Coverage. Youre given an annual allowance to spend on dental care. This information is neither an offer of coverage nor medical advice. So your share of the cost is usually lower. 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 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). They are not benefits under your insurance plan. Give your member information at your visit. Aetna Member Log-in - The tooth is an abutment to a covered partial denture or fixed bridge. Aetna may receive a percentage of the fee you pay to the discount vendor. The information you will be accessing is provided by another organization or vendor. Rendered before the effective date or after the termination of coverage, unless coverage is continued under the Special coverage options after your plan coverage ends section of your policy. 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 . The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Cigna DPPO networks offer convenient access to quality dentists all across the country and savings on covered dental services. Information is believed to be accurate as of the production date; however, it is subject to change. Network dentists also file claims for you. You can start using your plan right away! 2022 Aetna Dental 2 Enroll at www.BENEFEDS.com . Studies show that a healthy mouth helps you avoid health problems in the body, too. This information is neither an offer of coverage nor medical advice. Member Services: 1-877-238-6200 Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. That are cosmetic in nature. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. 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. Switch by the 15th day of the current month. There are no claims or referrals to worry about, and no limits on how much you can save. Each main plan type has more than one subtype. These dental benefits follow the same structure as network plans and may require you to choose a dental provider within your network. As you plan for your dental care, keep in mind that you may have limits on the amount of preventive care visits you can make each year, as well as caps on coverage for comprehensive services. You can also download it from the App Store or the Google PlayTM store. The school has chosen a plan that makes it easy to keep your smile. That would not be made if you did not have coverage. Reprinted with permission. 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. With Aetna Dental Direct, youll get the coverage you need to keep your teeth healthy. Get savings on weight-loss programs and meal plans, and enjoy one-on-one help, personalized menus, online tools and chat rooms. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Deductible and annual maximum amounts cross-apply between in network and out of network. Youcansee anylicenseddental provider in the U.S. You can use the allowance toward almost all dental services except for teeth whitening and a few administrative costs (e.g., missed appointments). Not available in many states. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Links to various non-Aetna sites are provided for your convenience only. 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. Dental plans are all different. Register to watch this video opens in a new tab to get answers to frequently asked questions about the Verizon Advantage plan.
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