Aetna Dental Insurance
Aetna Dental insurance offers several coverage options for individuals, families and groups. They have the nation's largest network of dentists for members to choose from, and their website offers a great user friendly array of online tools to manage your account with, from choosing a dentist to managing your claims. Most people covered by Aetna Dental get access to their dental insurance plans via their employer.
The big drawback with Aetna is that it provides individual plans only in five states, Alaska, Arizona, Delaware, Illinois and Pennsylvania. If you are self-employed or have no dental plan from an employer, and do not live in one of these five states, take a look at our other reviews of dental insurance companies.
For those in one of the five states, Aetna offers some decent plans. You can buy at their website, navigating to state specific pages through their "Buy Dental Coverage" page. You can save money on your dental visits, as Aetna pays expenses on exams and x-rays and most cleanings with the majority of its plans, as well as a percentage of major dental care. Up to 80 percent of denture repairs are covered. Those looking for crowns or dentures can expect to wait up to more than a year. Here's an overview of the dental insurance plans and coverage options offered by Aetna:
Dental Maintenance Organization Plans
Aetna offers Dental Maintenance Organizations (DMO) plans with dependable coverage and cost savings. The plans are easy to use. You must use a primary care dentist (PCD) from the Aetna network with this coverage option. Your PCD coordinates your dental care. Many preventive and major services are covered. Your PCD give you a referral when specialty care is needed. If you plan covers orthodontia, no referral is needed, but not every DMO plan covers orthodontia.
The DMO plan costs less than a traditional PPO dental insurance plan. The plan has no deductibles or dollar amount maximums, but in some cases age, frequency and orthodontia limits may apply.
You can choose from fixed or copay plans to keep your rates low. The DMO plan is available for fully insured customers.
Aetna also offers Preferred Provider Organization (PPO) dental plans. You have the flexibility to see any dentist but you save more when you use a network dentist. You do not need a referral to see the dentist of your choice. The PPO plan covers preventive, basic and major services. If you see a dentist in the Aetna network, they must stay with contracted rates set by Aetna. So you do save money staying within their network.
Members have a choice of benefit levels, deductibles, coinsurance and maximums. You can choose from self-funded or fully insured options including the Aetna Dental Care Reward plan and the Aetna DentalFund plan. The choices affect your monthly premiums and level of care. One of the choices is the low cost PPO plan, Aetna Dental Preventive Care.
Dental Indemnity Plans
Another coverage option from Aetna is the Dental Indemnity plans, where you can choose any dentist without a referral. Most preventive, basic and major services are covered. Deductibles, coinsurance and annual plan maximums do apply. You are responsible for paying at the time of dental service and then the plan reimburses you.
Aetna Dental offers a Hybrid plan, where members choose between the benefits of two plans. This plan gives businesses the chance to offer employees a DMO plan, with either a PPO or indemnity plan option. Employees can even switch between the optional plan each month with a call to member services, or they can log into the member website to switch.
Again, you save money if you use a dentist within the Aetna network with this plan. Members who switch to the PPO or indemnity plan gain access to a broader choice of dentists, but may pay more.
The big advantage here is for employers, who can provide a common plan across an entire company even if it has multiple business locations.
Managing Your Care
Aetna's website is user friendly. You can process and manage your claims online. You also make your payments online. Tools at the site make it easy to find a dentist.
You do not need a referral to see an orthodontist, but if you are a DMO member you must visit an orthodontist in the Aetna network. Check your coverage documents to see what level of orthodontic treatment is covered in your plan. Not all plans include orthodontic coverage.
Coverage of oral surgery varies from plan to plan. Aetna recommends you get an estimate on oral surgery procedures up from and submit it for review prior to treatment. You can also phone the Aetna Oral Surgery Center of Excellence to check coverage.
For the most part, you can manage your Aetna coverage from the members section of their website. The site has a good General Dental FAQ page, as well as FAQ pages for both PPO and DMO plans. You can contact Aetna Dental via phone and twitter. The contact options are specific to your plan, you must navigate through the website to find the specific phone numbers and contact options available for service for your plan. Some members report frustration with the phone support.
With Aetna Dental, some serious dental problems are covered only in very specific instances, such as crowns, inlays and labial veneers. The good news is that Aetna does cover the entire cost of preventative exams and x-rays with its premium plan.
Verdict - Good
Aetna Dental insurance is worth a serious look. The website provides a user friendly experience with good online tools. The network of dentists is huge and covers the full range of care. There is a variety of coverage options, good news for those on a budget. While these are some complaints about customer service, on balance they deliver. If you are shopping for individual dental insurance, Aetna is only available in Alaska, Arizona, Delaware, Illinois or Pennsylvania, so those in other states need to look elsewhere. Coverage options vary by state and offerings from employers