Dental benefits and dental insurance plans contain exclusions and limitations. When billing, you must use the most appropriate code as of the effective date of the submission. Network dentists offer special rates for covered services. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Aetna Student Health is offering a Dental Preferred Provider Organization (PPO) planto Columbia University students and their eligible dependents. All Rights Reserved. All Rights Reserved. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. For more information, please call HSA Consulting Customer Service at (888) 978-8355. Once youre a member, you have two ways to engage with your plan online. You are now being directed to CVS Caremark site. Click here to review plans with a $0 deductible. So, you wont see cost information here. 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. So, your share of the cost is usually lower. They are not benefits under your insurance plan. In Pennsylvania, the waiting period is called an elimination period and most Basic services have one month waiting period. Dental insurance plans are underwritten by Aetna Life Insurance Company. You can find a network provider by logging in as a member and going to our provider directory. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. your primary care dentist will refer you to one in our network. PLAN EXCLUSIONS AND LIMITATIONS* Digital tools to easily manage your care and access your ID card whenever needed. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. So, your share of the cost is usually lower. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. If you do not intend to leave Aetna Medicare, close this message. This is donethrough an optional supplemental benefit. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. 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). Some plans will cover around 50% of adult orthodontic treatment (including Invisalign), while others will only cover children up to 19 years old.
Aetna 2023 Medicare plans put money back in members' pockets And one of the main perks of joiningaMedicare Advantage (MA)planis that many plans offer dental coverage to helpyoukeep upwithyour oral health. Disclaimers. You may pay more when you get care from dentists who arent in the network.**. 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. Teeth whitening and facings on molar crowns and pontics will always be considered cosmetic. Language services can be provided by calling the number on your member ID card. Go to the American Medical Association Web site. 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. Direct member reimbursement allowance: How to get reimbursed for dental care. Some plans cover comprehensive services.
In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. We're here 8 a.m. - 8 p.m., Monday through Friday. For work-related conditions. Some preferred provider organization (PPO) and health maintenance organization point-of-service (HMO-POS) plans, however, do allow you to see any licensed dental provider, but you may save money by seeing a provider in our network. For additional language assistance: Choose from more than 120,000 dental providers nationwide, including providers who offer virtual visits through tele-dentistry. Aetna does not endorse any vendors, products or services associated with this program. Student health insurance plans are underwritten by Aetna Life Insurance Company (Aetna). You are leaving our Aetna Medicare website and going to an Aetna Medicaid website. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Links to various non-Aetna sites are provided for your convenience only. Member Services: 1-877-238-6200 The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Aetna handles premium payments throughInstaMed, a trusted payment service.
Benefits / Dental - browardschools.com Cancelled or missed appointment charges or charges to complete claim forms. Studies show that a healthy mouth helps you avoid health problems in the body, too. Dental care is a vital part of maintaining yourhealth and well-being, especially as you age. Treating providers are solely responsible for medical advice and treatment of members. 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. CPT only copyright 2015 American Medical Association. Whether youre at your desk or on the go, our easy-to-use digital tools help you manage your dental plan, save money and make smart decisions about your care. Choose any licensed dentist for care, but you can save by using an in-network dentist in your plan's network. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. You can choose from one of the more than 420,000 dentist locations in the Aetna Dental PPO network. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. ChooseHealthy is a federally registered trademark of ASH and used with permission herein. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna Medicare Advantage plans provide benefits that original Medicare does not. 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. Some subtypes have five tiers of coverage. You also have the flexibility to visit a licensed dentist who does not participate in our network. You pay up front for dental care and submit receipts for reimbursement. Youre given an annual allowance to spend on dental care. Network dentists also file claims for you. Get lower rates when you go to a dentist thats in your PPO network. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. Aetna will expand the Total Choice dental benefit introduced in 2022 to additional Individual MA HMO-POS and PPO plans. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Actual costs and savings may vary by provider, service and geographic location. This Agreement will terminate upon notice if you violate its terms. The amount of the discounts will vary depending on the provider and type of service or supply received. Pay less for acupuncture,* chiropractic visits, therapeutic massage and nutrition services** and for products like wearable fitness devices and fitness kits. Preferred Provider Organization (PPO) plans. Information is believed to be accurate as of the production date; however, it is subject to change. That are experimental or investigational. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Applicable FARS/DFARS apply. The SBC shows you how you and the plan would share the cost for covered health care services. Just check with your employer to see which plans are available to you. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Links to various non-Aetna sites are provided for your convenience only.
PDF Summary of Benefits and Coverage: What this Plan Covers - Aetna Feds Dual Eligible Special Needs Plans (D-SNP). If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. It gives members access to discounted fees according to schedules negotiated with providers by Aetna Life Insurance Company for Aetna Vital Savings. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. Special perks and discounts, including exclusive offers from CVS Health, Search for providers in-network by using our. With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. Preventive services (cleaning, x-rays, exams, etc.)