Often asked: What Does Aetna Pay For Dental Claims In Nassau County Ny?

Does Aetna cover dental?

Aetna does not provide dental, medical, vision or other health care/treatment. All care is the responsibility of the treating provider, in consultation with the participant.

What is Aetna PPO dental plan?

Under the Dental ® Preferred Provider Organization ( PPO ) plan, you may choose at the time of service either a PPO participating dentist or any nonparticipating dentist. With the PPO plan, savings are possible because the participating dentists have agreed to provide care for covered services at negotiated rates.

What is the copay for Aetna PPO?

Participating Physician Office Visit Participating Providers $25 Copayment per visit Non-Participating Providers 40% of Allowance Specialist Office Visit Participating Providers $50 Copayment per visit Non-Participating Providers 40% of Allowance Surgical Care in Ambulatory Surgical Center or other Outpatient Medical

How long does Aetna take to process a claim?

If we had to approve your claim before you got care, we will decide within 30 days of getting your appeal. For other claims, we’ll decide within 60 days.

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Is Aetna HMO or PPO better?

A Preferred Provider Organization ( PPO ) has pricier premiums than an HMO or POS. But this plan allows you to see specialists and out-of-network doctors without a referral. If you know you’ll need more health care in the coming year and you can afford higher premiums, a PPO is a good choice.

How much does Aetna dental insurance cost?

If you’re looking for a plan for your family, pricing starts at under $16 per month. The Aetna Dental Access and Aetna Vital Dental Savings Plus Rx plans offer similar advantages on resource ranging from preventative care to dental prescriptions.

Is there a dental plan that covers everything?

Indemnity insurance is as close as you’re likely to come to getting dental insurance that covers everything. With indemnity dental insurance, you can visit any dentist – there are no networks or approved providers.

Does Aetna Dental PPO cover implants?

Most of Aetna’s traditional medical plans do cover replacement of teeth as a result of a non-biting injury. In situations where replacement of the tooth/teeth is accomplished by dental implants, the dental crown is also a covered medical expense.

What is the best dental plan for seniors?

The 7 Best Dental Insurance Providers for Seniors in 2021

  • Best for Preventive Care: Cigna.
  • Best for Provider Flexibility: Aflac.
  • Best for Annual Maximums: Renaissance Dental.
  • Best for Affordable Options: Humana.
  • Best for Fast Coverage: United Healthcare.
  • Best for Largest Provider Network: Aetna.
  • Best Value: Delta Dental (AARP Member Plans)

Is Aetna a good insurance?

Aetna has an excellent reputation and is one of the largest health insurers in the U.S. It has an AM Best “A” (excellent) financial strength rating. Aetna offers several types of provider plans including HMO, POS, PPO, EPO, and HDHP with HSA.

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Why would a person choose a PPO over an HMO?

Advantages of PPO plans A PPO plan can be a better choice compared with an HMO if you need flexibility in which health care providers you see. More flexibility to use providers both in-network and out-of-network. You can usually visit specialists without a referral, including out-of-network specialists.

Does Aetna have a deductible?

Your doctor may bill you for the dollar amount that Aetna doesn’t “recognize”. You must also pay any copayments, coinsurance and deductibles under your plan. No dollar amount above the “recognized charge” counts toward your deductible or out-of-pocket maximums.

Why does my Aetna claim say denied?

When we do not pay for a service, it is called a denied claim. If your claim is denied, we will send you a letter to let you know. If you don’t agree, you can file an appeal. Once there are no appeals left, independent doctors may review your denied claim.

Can I submit claims to Aetna online?

Submitting your claims electronically is quick, convenient and easy. Choose the option that works best for you.

How do I get my Aetna fee schedule?

How to access your fee schedule

  1. If you’re affiliated with an Independent Practice Association (IPA), contact your IPA for a copy of your fee schedule.
  2. If you’re directly contracted with Aetna, you can call our Provider Service Center for help with up to ten Current Procedural Terminology® (CPT®) codes.

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