Aetna dental plans offer several options designed to provide comprehensive dental care, but understanding what procedures are covered is essential when considering treatment. While Aetna covers many preventive and restorative treatments, cosmetic dentistry procedures are typically not included unless deemed medically necessary.
Disclaimer:
Pacific Dental & Implant Solutions is not an insurance provider, and all information provided regarding dental coverage is based on our experience working with these plans. Plan details, coverage limitations, and benefit structures can change at any time. While our Billing department is happy to work with you on maximizing your plan coverage and benefits, we encourage all patients to refer to their specific plan documentation or contact your dental insurance provider directly for the final determination regarding coverage. Insurance verification by our team is provided as a courtesy, but ultimate responsibility for understanding your benefits lies with you as the policyholder.
Devoted Health Dental Coverage Overview
At Pacific Dental & Implant Solutions (PDIS) in Honolulu, we help patients navigate their Aetna dental insurance benefits. Our team works directly with Aetna to ensure smooth claims processing and to help you understand your coverage before treatment begins.
Want help understanding your exact coverage and benefits?
Schedule a free insurance verification with our team, and we’ll break down your specific Aetna Dental benefits before you begin treatment.
Network Status
Pacific Dental & Implant Solutions accepts Aetna dental insurance, and patients with Aetna plans may have access to the following benefits:
- Streamlined claims processing
- Negotiated in-network rates (if applicable)
- Direct insurance verification
- Transparent out-of-pocket cost estimates
Our team can quickly verify your specific Aetna plan details and help you understand your coverage before any procedure, ensuring transparency and informed decision-making.
Coverage Limits
Devoted Health dental plans offer varying levels of coverage with annual maximums ranging from $250 to $3,000. Our practice assists patients in understanding their unique coverage, including:
- Preventive services typically covered at 100%
- Cosmetic procedures explicitly excluded
- Potential limitations on specific treatments
We recommend scheduling a pre-treatment consultation where our insurance specialists can provide a detailed breakdown of your expected coverage and potential out-of-pocket expenses.
Waiting Periods
Aetna dental plans generally do not have waiting periods for preventive services, but basic and major procedures may be subject to waiting periods depending on the plan. Our insurance specialists can help clarify your waiting period requirements and explore financing options if necessary.
What Cosmetic Dental Procedures Does Aetna Cover?
Aetna focuses on medically necessary dental treatments. Cosmetic procedures are typically excluded unless they also serve a functional purpose, such as restoring a damaged tooth. Below is an overview of coverage for specific procedures:
Dental Implants
Aetna dental plans generally do not cover dental implants. However, some plans may provide coverage for the final restoration (such as the crown) as an alternative service. Our team can help explore insurance options and financing alternatives.
Dental Crowns
Aetna covers crowns when deemed medically necessary. Typically, coverage falls under major services, requiring 50% coinsurance after the deductible is met. Coverage limitations may apply based on the type and frequency of previous crown placements.
Dental Bridges
Bridges may be covered under major procedures at the 50% coinsurance level. Similar to crowns, coverage is typically only available if the procedure is deemed medically necessary and subject to waiting periods and plan limitations.
All-On-Four
Aetna dental insurance does not specifically cover All-on-4 implant solutions. While certain components, such as dentures or abutments, may have partial coverage, the full procedure is typically considered an out-of-pocket expense. Our office can assist in finding cost-effective solutions.
How to Use Your Aetna Dental Insurance at PDIS
At Pacific Dental & Implant Solutions, we streamline the insurance process to make it easier for our patients to understand and maximize their Aetna benefits.
Verification Process
Our team will conduct a free insurance verification to review your Aetna plan, including coverage percentages, annual maximums, waiting periods, and exclusions.
Pre-authorization Requirements
Certain procedures, such as crowns or bridges, may require prior authorization from Aetna. We handle all pre-authorization submissions, ensuring all necessary documentation is provided for a smoother approval process.
Coverage Tiers and Network Details
As an Aetna-friendly provider, our office ensures that patients receive the most out of their benefits while minimizing unexpected costs. If your plan includes out-of-network benefits, we will guide you on how to use them effectively.
Understanding Your Out-of-Pocket Costs with Aetna Dental Insurance
We strive to make dental care as affordable as possible, even when insurance does not fully cover a procedure.
Deductibles
Most Aetna PPO plans include a $50 per-person deductible ($150 per family), which applies to basic and major procedures. Preventive care is typically exempt.
Copayments and Coinsurance
Patients can expect to pay the following, depending on their plan:
- Preventive Services: $0 (fully covered)
- Basic Procedures: 20-50% coinsurance
- Major Procedures: 50% coinsurance
Annual Maximums
Aetna PPO plans generally have annual maximums ranging from $1,000 to $1,250, after which additional costs become out-of-pocket expenses.
Next Steps: Schedule Your Consultation
Ready to use your Aetna Dental benefits at PDIS? Schedule a consultation below. When you visit, please bring along your insurance card and a valid photo ID. Having these materials ready will help us provide the most comprehensive evaluation of your needs and insurance coverage. We look forward to serving you soon!