Important telephone numbers and addresses
Under the DMO dental plan, services performed by specialists are eligible for coverage only when prescribed by the primary care dentist and authorized by Aetna Dental. If Aetna's payment to the specialty dentist is based on a negotiated fee, then the member's copayment for the service will be based on the same negotiated fee. You pay $0 copay, for cleanings and X-Rays, when you use our dental preferred provider organization (PPO) network.A formulary is a list of generic and brand-name drugs your health plan prefers. If you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the difference between the generic. AETNA DENTAL DMO & PPO COMPARISON PLAN FEATURE DMO BENEFIT PPO / IN NETWORK PPO / OUT OF NETWORK Plan Type Fixed Copay Plan N/A N/A OfficeVisit Copay $5 N/A N/A Coinsurance – Preventative Set Reduced Fee 80% 80% Coinsurance – Basic Set Reduced Fee 60% 60% Coinsurance – Major Set Reduced Fee 40% 40% Deductible N/A $50 $50. Aetna may receive a percentage of the fee you pay to the discount vendor. Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825, is the Discount Medical Plan Organization. You are entitled to choose any participating dentist listed in Vital Savings by Aetna®. Dental offices are located throughout the United. An example of how it works: Courtney, 43, is a single lawyer who just bought her first home, a condo in Midtown Atlanta. She loves that her building has a gym and pool because she likes to stay in shape. When she felt a lump in her breast during a self-exam, she immediately had it checked out.
Dentist Hotline
- National Dentist Line: Have a question? Call the National Dentist Line at 1-800-451-7715.
- Dentist Contracting Hotline: For PPO contract information, call the Dentist Contracting Hotline at 1-800-776-0537.
Important addresses
All dental encounters
Aetna Dental Encounters
P.O. Box 14530
Lexington, KY 40512
For your convenience, we have a single post office box for claims and specialty authorization submissions. The Aetna Grievance and Appeals Unit also has one box for all states except California, which has a separate box.
All claims and specialist authorizations
Aetna Dental
P.O. Box 14094
Lexington, KY 40512-4094
All dental Medicare claims
Aetna Medicare
PO Box 7762
London, KY 40742
Aetna DMO® and PPO grievance and appeals
All states except California:
Aetna Dental
P.O. Box 14597
Lexington, KY 40512-4597
California only:
Aetna Dental
P.O. Box 10462
Van Nuys, CA 91410
Want to become a participating dentist?
Call our National Dentist Line at 1-800-451-7715 or visit Information about Aetna Dental Networks.
Aetna website
You can request more information 24 hours a day at www.aetna.com.
At a glance
- $0 premium plans available in some areas
- Many plans offer prescription drug coverage and routine vision and dental benefits
- About 2.6 million people are enrolled in an Aetna Medicare Advantage Plan1
Certain Aetna Medicare Advantage plans may offer coverage for dental care.
Medicare Part A will pay for certain dental services when you’re in the hospital. It doesn’t cover routine dental care. Aetna Medicare Advantage plans offer the same coverage as Original Medicare, and some plans may offer additional benefits that cover routine dental services like cleanings and fillings.
What dental services may be covered by an Aetna Medicare plan?
If you enroll in an Aetna Medicare Advantage plan that includes dental coverage, some of the services that may be covered include:
- Teeth cleaning, scaling and polishing
- Office visits for oral examinations
- Non-surgical extractions
- Fillings
- Minor denture adjustments
- X-rays
- Oral hygiene instruction
- Dietary advice and counseling
- Minor bite adjustments
Plan details vary and some plans may provide broader dental coverage than others. Check your plan’s Explanation of Coverage (EOC) to see exactly what dental coverage benefits may be offered by your plan.
If your Aetna Medicare Advantage plan offers dental benefits, the costs for your covered dental services may be included in the plan’s premium or as an Optional Supplemental Benefit, which means you would need to pay an additional premium.
An Aetna Medicare Advantage plan that covers dental care may offer the benefits through an allowance or via a network of approved dental care providers.
If your Aetna Medicare plan offers dental coverage through an allowance, you pay up front and submit a receipt for reimbursement. You can see any licensed dental care provider for approved services.
If your Aetna Medicare plan offers dental benefits through a network of providers, you’re required to see an approved in-network provider for covered services.
How do I enroll in an Aetna Medicare Advantage plan?
Aetna Copay Plans
A licensed insurance agent can help you compare Aetna Medicare Advantage plans available where you live.
Aetna Copay Amounts
Speak with a licensed insurance agent by calling 1-877-890-14091-877-890-1409TTY Users: 711 24 hours a day, 7 days a week.
Aetna Dental Copay
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