Aetna Dental has the following dental coverage plans available: direct preferred PPO, direct core PPO, and direct preventive PPO.
Aetna dental coverage plans
Obtain the coverage you require to maintain the health of your mouth, teeth, and gums. You don’t need to have Aetna medical or other coverage with Aetna to purchase the Aetna Dental PPO plan because preventive oral care is fully covered with no out-of-pocket expenses.
When you convert from your current comparable plan to an Aetna plan, the waiting period for major procedures such as crowns or root canals—which are typically subject to waiting periods under most dental insurance policies—will be waived. As a result, you can immediately use your plan.
Aetna Dental® Direct Preferred PPO
Aetna Dental® Direct Preferred PPO provides the highest level of coverage if you need more than routine dental care. Get an estimated 100% or full coverage for preventive dental services like oral exams, cleanings, full mouth x-rays, and sealants with no waiting period. Aetna Dental® Direct Preferred PPO covers an estimate of 20% of basic dental services such as resin fillings, periodontal maintenance cleanings, and simple tooth extractions with a 6 month waiting period. Major dental services namely root canals, dental crowns, and dentures are estimated to be 50% covered with a waiting period of 12 months.
Note that the waiting period will be waived if everyone enrolling in the plan has had dental insurance within the last 90 days; otherwise, everyone applying will need to complete the waiting period before services are covered.
Aetna Dental® Direct Core PPO
Aetna Dental® Direct Core PPO is the same as the Preferred plan with a lower monthly premium, but you may pay more for services. With Aetna Dental® Direct Core PPO, you can get an estimated full or 100% coverage for preventive oral services such as dental exams, teeth cleanings, full mouth x-rays, and dental sealants with no waiting period. Aetna Dental® Direct Core PPO plan offers an estimated 50% coverage of basic oral care namely resin fillings, periodontal maintenance cleanings, and simple extractions with a waiting period of 6 months. Major dental services like root canals, crowns, and dentures are estimated to be 50% covered with a o12 month waiting period.
Keep in mind that the waiting period will be waived if everyone applying in the plan has had dental insurance within the last 90 days; or else, everyone enrolling will have to complete the waiting period before services are insured.
Aetna Dental® Direct Preventive PPO
Aetna Dental® Direct Preventive PPO is for the budget-conscious coverage for routine care with the lowest cost monthly premium. You can get an estimated full (100%) coverage for preventive oral services such as dental exams, teeth cleanings, full mouth x-rays, and dental sealants with no waiting period under Aetna Dental® Direct Preventive PPO plan. There is no annual maximum benefit and no deductible for this plan.
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Aetna Dental tooth extraction cost coverage?
Aetna Dental plan covers an estimated 20%-50% of simple extractions with a 6 month waiting period. There’s no waiting period for basic dental services like simple tooth extractions if all enrolled family members had dental coverage within the past 90 days of enrollment. See the insurance policy for the plan you choose to learn more about covered services and benefit levels. Source
Aetna Dental covers Wisdom teeth removal?
Wisdom teeth removal is considered an oral surgery. For oral surgeries like wisdom tooth extraction, Aetna dental plans typically provide a coverage of between an estimate of 50% and 70%. To find out the conditions under which your wisdom teeth removal will be covered (and at what rates of coverage with relevant limits), read up on the coverage in the benefits part of your insurance policy and compare it to the one you’ll probably switch to. Source
Does Aetna dental cover X-Rays?
Aetna Dental covers an estimated 100% of bitewing X-rays once per year. Aetna dental plans also offer full coverage for full mouth x-rays in-network and 20% coverage for out-of-network. Members can immediately start using their benefits for preventive dental services. Source
Aetna Dental covers Braces?
Aetna Dental covers an estimated 50% of braces costs; however, there are certain limitations. For those under 19, braces are often covered by Aetna dental insurance. There are also Aetna dental insurance policies that will pay for adult orthodontic treatment depending on the plan. There can be further restrictions, such as a lifetime limit or a waiting period, even if you are granted coverage. Source
Is Invisalign covered by Aetna dental?
Aetna dental offers an estimate of 50% coverage for Invisalign treatment cost up to $2,500. Typically, many Aetna Dental PPO plans cover $500, $1000, or $1250 for Invisalign aligners. The Invisalign benefits under Aetna Dental are impacted by age restrictions. Source
What does Aetna dental cover for dental implant?
Aetna Dental may cover part of the dental implant procedure depending on your specific plan and coverage. Please give us a call to find out what might be covered for your specific situation.
Does Aetna Dental cover dentures?
Aetna dental offers an estimate of 50%-70% coverage for dentures with a waiting period of 12 months. Your initial installation of dentures will be covered only if they are required to replace one or more natural teeth that were extracted while this policy was in effect or if a partial denture does not have abutments that were put in place within the previous 8 years. Note that out-of-network benefits are subject to certain charge limits. You may be billed by out-of-network dentists up to the dentist’s standard fee. Source
How much does Aetna Dental cover for Veneers?
Unfortunately, cosmetic dentistry treatments like dental veneers are not covered by Aetna dental insurance. Nevertheless, replacing tooth fillings and dental crowns can be covered even if they are done for cosmetic purposes. Source
Aetna dental accepted for Gum Grafts?
Aetna Dental may cover part of gum grafts depending on your specific plan and coverage. Please give us a call to find out what might be covered for your specific situation.
Does Aetna Dental cover Cleaning and Tooth Fillings?
Aetna dental offers full coverage for teeth cleanings for in-network while an estimated 20% coverage is provided for out-of-network patients. Resin fillings are estimated to be 20%-50% covered. The waiting period is waived if all registered family members received dental coverage within the previous 90 days. In-network and out-of-network patients are both subject to the same deductible and yearly maximum payments. Deductible only applies to basic oral services such as fillings. Source
For latest information, please visit: https://www.aetna.com/individuals-families/buy-dental-coverage.html for more details.
DISCLAIMER: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information, please see the insurance company’s website or call the customer service or member services number listed on most insurance ID cards. Updated as of 06/12/2023. The above logo & trademarks are property of Aetna Dental.