Aetna Dental

With the Aetna Dental PPO Max insurance plan, participating dentists provide covered services at negotiated rates and may also provide discounts on non-covered services such as cosmetic tooth whitening and orthodontic care, so you generally pay less out of pocket. You also have the flexibility to visit a dentist who does not participate in the Aetna network, though you will not have access to negotiated fees. Note: Dental coverage is available only if you purchase Aetna health insurance coverage. Discounts for non-covered services may not be available in all states.

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Aetna Dental Benefits

Participating dentists may offer discounted rates on additional services such as tooth whitening. Discounts for non-covered services may not be available in all states. Nonpreferred (Out-of-Network) Coverage is limited to a maximum of the Plan’s payment, which is based on the contracted maximum fee for participating providers in the particular geographic area. The below list of covered services is representative. A summary of exclusions is listed in the Aetna Advantage Plan brochure. For a full list of benefit coverage and exclusions refer to the plan documents. This material is for information only. Dental insurance plans contain exclusions and limitations. Not all dental services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. Aetna Advantage Plans for Individuals, Families and the Self-Employed are underwritten by Aetna Life Insurance Company (Aetna) directly and/or through an out-of-state blanket trust or Aetna Health Inc. In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans. To the extent permitted by law, these plans are medically underwritten and you may be declined coverage in accordance with your health condition. * Discounts for non-covered services may not be available in all states.

Aetna Dental Plan In Network

Individual Aetna Dental PPO Max plan: Member Benefits
Annual Deductible per Member (Does not apply to Diagnostic and Preventive Services): Individual $25; Family $75
Annual Maximum Benefit - Unlimited

Deductible is waived for the following services
Diagnostic Services - Oral Exams - Periodic oral exam - Comprehensive oral exam - Problem-focused oral exam - X-rays - Bitewing-single film - Complete series - Preventive Services - Adult cleaning - Child cleaning - Fluoride application-with cleaning

Space maintainers: Sealants-per tooth: Discount; Discount; Basic Services -  Amalgam fillings-2 surfaces: 0% after deductible, Resin fillings-2 surfaces: Discount; Oral Surgery - Extraction-exposed root or erupted tooth: Discount, Extraction of impacted tooth-soft tissue: Discount; Major Services - Complete upper denture: Discount, Partial upper denture (resin based): Discount, Crown-Porcelain with noble metal: Discount, Pontic-Porcelain with noble metal: Discount, Inlay-Metallic (3 or more surfaces): Discount; Oral Surgery - Removal of impacted tooth-partially bony: Discount; Endodontic Services - Bicuspid root canal therapy: Discount, Molar root canal therapy: Discount; Periodontic Services - Scaling and root planning-per quadrant: Discount, Osseous surgery-per quadrant: Discount; Orthodontic Services: Discount

Aetna Dental Plan Out Of Network

Individual Aetna Dental PPO Max plan: Member Benefits - Annual Deductible per Member (Does not apply to Diagnostic and Preventive Services): $25; $75 family maximum; Annual Maximum Benefit: Unlimited; Diagnostic Services - Oral Exams - Periodic oral exam: 50% deductible waived, Comprehensive oral exam: 50% deductible waived, Problem-focused oral exam: 50% deductible waived; X-rays - Bitewing-single film: 50% deductible waived, Complete series: 50% deductible waived; Preventive Services - Adult cleaning: 50% deductible waived, Child cleaning: 50% deductible waived, Sealants-per tooth: Not covered, Fluoride application-with cleaning: 50% deductible waived, Space maintainers: Not covered; Basic Services - Amalgam fillings-2 surfaces: 50% after deductible, Resin fillings-2 surfaces: Not covered; Oral Surgery - Extraction-exposed root or erupted tooth: Not covered, Extraction of impacted tooth-soft tissue: Not covered; Major Services - Complete upper denture: Not covered, Partial upper denture (resin based): Not covered, Crown-Porcelain with noble metal: Not covered, Pontic-Porcelain with noble metal: Not covered, Inlay-Metallic (3 or more surfaces): Not covered; Oral Surgery - Removal of impacted tooth-partially bony: Not covered; Endodontic Services - Bicuspid root canal therapy: Not covered, Molar root canal therapy: Not covered; Periodontic Services - Scaling and root planning-per quadrant: Not covered, Osseous surgery-per quadrant: Not covered; Orthodontic Services: Not covered