With Aetna Dental® DMO*, you get quality dental coverage that fits everyone’s budget. An in-network primary care dentist (PCD) guides members’ care, with no deductibles, paperwork or hassles. It’s the simple way to care for smiles.
Plan features:
If your members like freedom, they’ll love Aetna Dental PPO. They can pay a little more to visit any out-of-network dentist. Or, stay in our broad network to budget and save. There are no referrals required either way.
Plan features:
With the Aetna Dental indemnity plan, members can visit any licensed dentist, anywhere in the country. And pay the bill direct to their dentist. They may have to file a claim to get reimbursed, but they’ll never have to worry about choosing a PCD or getting referrals.
Plan features:
With Aetna Freedom-of-Choice, members can switch between two plans — with two networks — to fit changing needs. For one price, choose Aetna DMO for the simplicity and savings of in-network, PCD-guided care. Or choose our PPO or indemnity plan for the freedom to visit any provider, anywhere. In fact, members can switch between two plans every month. It’s that easy.
Plan features:
It’s easy with our range of vision, pharmacy and other complementary benefits. They’re available standalone or with any medical plan. Your Aetna rep can tell you more.
You’ve got the right dental insurance plan. Now count on Aetna to find the right programs, services and administration to keep your benefits and business running smooth.
Keep members healthy and engaged with programs and services that keep whole health in mind.
Complete your dental plan with protection for every benefit need — from group medical to Medicare to vision and beyond.
Explore quoting, enrollment and reporting tools to ease administration for plan sponsors and brokers.
Four dental insurance plan options for flexibility, savings and freedom.
*State laws vary with regard to out-of-network benefits. In Illinois, DMO plans provide limited out-of-network benefits. However, in order to receive maximum benefits, members must select and have care coordinated by a participating primary care dentist. Illinois DMO is not an HMO. In Virginia, the DMO® plan is known as the DNO plan. DNO (Dental Network Only) in Virginia is not an HMO. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with in-network providers.
In Idaho, dental benefits and dental insurance plans are offered and/or underwritten by Aetna Life Insurance Company. In Texas, the Aetna Dental PPO insurance plan is underwritten by Aetna Life Insurance Company. For all other states, dental benefits and dental insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Life Insurance Company (Aetna). Each insurer has sole financial responsibility for its own products.
Dental benefits and dental insurance plans contain exclusions and limitations.
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Links to various non-Aetna sites are provided for your convenience only. 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.
Links to various non-Aetna sites are provided for your convenience only. 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.
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Links to various non-Aetna sites are provided for your convenience only. 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.
Links to various non-Aetna sites are provided for your convenience only. 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.
Links to various non-Aetna sites are provided for your convenience only. 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.
Links to various non-Aetna sites are provided for your convenience only. 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.
Links to various non-Aetna sites are provided for your convenience only. 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.
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Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. 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. Do you want to continue?
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The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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.
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. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.
Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.
Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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.
