Choose from leading manufacturers and get free follow-up service for one year. You should: Review the Electronic Claim Vendor List Electronic Claim Vendor List. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Select a state below to update coverage details. Do you cover implants? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. ***Certain brands impose a no-discount policy. When you have an Aetna Dental plan, you know youre taking the right steps toward being healthy. 1999- Rates start at $7.99 a month. Get a discount on blood pressure montiors, pedometers, activity trackers, pain relief devices and other Omron products. In Pennsylvania, the waiting period is called an elimination period and most Basic services have one month waiting period. Digital tools to easily manage your care and access your ID card whenever needed. Visit any licensed dentist outside the network. And you don't have to have Aetna medical or other coverage with us to purchase. No fee schedules, basic unit, relative values or related listings are included in CPT. Why choose ${company} Medicare Solutions? One thing to keep in mind as you plan for dental care with this plan is that the cost of certain dental procedures and services can vary according to each provider. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. The information you will be accessing is provided by another organization or vendor. Visit the secure website, available through www.aetna.com, for more information. Or log in to your member account to submit the form online. When billing, you must use the most appropriate code as of the effective date of the submission. Medicare Advantage PPO Plans | Aetna Medicare Program providers are solely responsible for the products and services they provide. Each main plan type has more than one subtype. A primary care dentist (PCD) helps guide your care with this DMO* plan. No fee schedules, basic unit, relative values or related listings are included in CPT. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Vision and hearing at no additional cost. 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 the waiting period. 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. 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. Learn about Medicare Advantage The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Not available in many states. The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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. 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. Orthodontic treatment except as covered in the Eligible Dental Services section of your insurance policy Consent is not required to download the app. 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. What does the Aetna Dental PPO Plan cover? So your share of the cost is usually lower. Please be sure to add a 1 before your mobile number, ex: 19876543210. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. PDF Summary of Benefits and Coverage: What this Plan Covers - Aetna Feds 1According to the Aetna Enterprise Provider Database as of May 1, 2018. Links to various non-Aetna sites are provided for your convenience only. Members should discuss any matters related to their coverage or condition with their treating provider. 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. Or it may be coinsurance, which is a percentage of the dentists charge. You will receive the discount off the providers usual and customary fees when you pay. Note not all Aetna dental plans and offers available in all markets. The following information is about the Aetna Medicare Choice Plan (PPO) formulary (or drug list). Pros. Welcome Federal Employees | AetnaFeds.com - FedVIP FAQs PDF A Nationwide Dental PPO Plan - Aetna Feds With Medicare Advantage plans that include a network dental benefit, youre covered up front for specified dental services but may be required to see a dentist within your network of providers. Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Preventive services such as cleanings, oral exams and X-rays are covered at 100 percent on most plans. Please log in to your secure account to get what you need. Dental Preferred Provider Organization (PPO) FAQs | Aetna The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. The material is for information only. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. Your InstaMed log in may be different from your Caremark.com secure member site log in. Get savings on weight-loss programs and meal plans, and enjoy one-on-one help, personalized menus, online tools and chat rooms. See your Evidence of Coverage for details. Aetna Dental Insurance Plans for Seniors in 2023 - The Senior List 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. Dental Insurance Plans for Individuals & Families | Aetna All services deemed "never effective" are excluded from coverage. For prescribed drugs, pre-treatments or analgesia. Links to various non-Aetna sites are provided for your convenience only. 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. For language services, please call the number on your member ID card and request an operator. All Aetna Dental plans offer a wide choice of dentists, wellness discounts and convenient digital tools. 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. Replacement of teeth beyond the normal complement of 32 . 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. Click the Register button to get started. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). If you do not intend to leave our site, close this message. Welcome Federal Employees | 2022 Plan Brochures - Aetna Feds
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