Aetna is an insurance company that has been around since 1853. Yeah, you read that right. Dental insurance is one of several types of health coverage offered by Aetna and they have over 50 years of experience offering dental plans. It was introduced later as the company continued to expand its services. When you think about it, experience is definitely part of Aetna, especially since they have been in business for more than 15 decades (and based on the Aetna Dental reviews online it shows). Regardless, is Aetna the best dental insurance? Well, that just depends on you, your location, and your needs. Let’s review the details, so you can decide for yourself if is Aetna dental insurance good for you.
Aetna Dental Insurance: What Does It Offer?
For dental insurance through employers, Aetna offers three different dental plans consisting of a Preferred Provider Organization (PPO/DPPO) plan, a Dental Maintenance Organization (DMO) plan, and a Dental Indemnity plan. For self-funded dental plans, Aetna offers two options consisting of Aetna Dental® Direct Preferred PPO and Aetna Dental® Direct Core PPO.
Aside from that, you can get a dental discount plan that is NOT insurance, but it does offer big savings on dental services and prescriptions instead of providing payments towards them.
|Insurance||How is it obtain?||Dentists||Which can I choose?||Can I change dentist?|
|Aetna DMO Plan||Obtainable through employers||Uses a network of providers. The dentists are contracted with Aetna to provide dental work to patients at discounted rates.||Requires you to choose a primary provider that is in Aetna’s network of providers.||You cannot change dentists for 1 year after choosing your primary dental professional and it repeats every year after that. Specialty services require a referral.|
|Aetna PPO Dental Plan||Obtainable through employers||It does include the network of providers like the DMO plan, but you can choose any dental professional you like and still use your insurance benefits.||The networked providers agreed to discounted services so it is always best to choose one whenever possible to help cut your out-of-pocket costs.||It has higher premiums and deductibles than other individual dental insurance options and is has a maximum coverage limit.|
|Aetna Preferred PPO Deltan Plan||Obtainable through employers||You can choose any dental professional you want||You will receive discounted pricing and full benefits for in-network providers|
|Aetna Direct Core PPO Dental Plan||(available as self-funded)||Allows you to choose any dental professional you want||You’ll get full coverage and discounted service costs when choosing an in-network provider.|
|The Aetna Dental Indemnity Plan||(obtainable through employers)||You choose any dentist, anywhere, and at any time.||This plan does not use or include a network of providers like PPO/DPPO and DMO plans.||You can switch dentist anytime you desire without losing your dental coverage. Referrals for specialists are not required either. The maximum coverage limits are higher, and deductibles are the highest in comparison to the PPO plan.|
Aetna dental insurance is not available in all zip codes and states. Some websites claim it is only available in Alaska, Arizona, Delaware, Illinois, and Pennsylvania. If you live in another state, contact Aetna to see if a dental insurance plan is actually offered in your area or to find other options to get dental coverage, such as through a health insurance plan.
Aetna Dental Discount Plan Review
Aetna also offers dental discount plans, so we did an Aetna Dental Discount Plan review too. Known as Aetna Vital Dental Savings℠, this dental discount plan can be used to save money on typical dental services and products. They provide savings as much as 50% for various dental procedures. Discounts can be applied to braces, dentures, crowns, dental cleanings, dental implants, root canals, X-rays, and much more. They also cover specialty dental services from orthodontists, oral surgeons, endodontists, and other specialty dental services.
Aetna Dental Savings Plan Details
Note: Dental discount plan details are subject to changes at any time.
Aetna Dental Discount Plan Pricing
Note: Pricing varies based on service location and local provider charges. Any amounts specified are for reference only.
*Price listed is not an estimate and is subject to change, and it is the same for everyone.
Aetna dental® has over 339,000 dentists in their PPO network of providers, as well as many orthodontists and other dental specialists. They also have dentists and dental specialists in Mexico if traveling abroad.
Aetna’s In-Network dental professionals include:
Both adult and primary dentists mentioned in the list above refer to in-network dentists that can be used under DMO and PPO dental plans. Each type of plan will have its own list of in-network providers, mainly because it is up to the doctor/dentists to decide which programs they want to participate in. Their decisions are based on the benefits incurred for each type of dental insurance. PPO insurance is more popular than DMO, but Aetna has a huge database of participating DMO providers too. Pediatric dentists specialize in child dental needs and this category applies to family plans versus Aetna individual dental insurance plans.
How Much Does Aetna Dental Insurance Cost and What Does It Cover?
Aetna offers a variety of dental insurance plans through Aetna Dental® Direct for individuals and also offers several dental insurance packages through employers. Employer-sponsored dental plans from Aetna vary in price from one employer to another and can be chosen during open enrollment. Aetna Individual insurance plans (self-funded plans) can be found at https://dentaldirect.aetna.com/ after you get an online quote on the same website. Generally speaking, individual Aetna dental insurance plans can be anywhere between $30 and $60 per month. This is not to be confused with the two options for coverage, including individual and family dental coverage. The term “individual” in this context is referring to the type of dental insurance. The other option is employer dental insurance. Your pricing for individual dental insurance will be based on various factors, one of which includes your location.
Aetna Dental® Direct insurance options cover a wide variety of dental services from routine cleanings and fillings to major dental work like oral surgery and root canal therapy.
Dental Services Covered under Aetna Dental® Direct Coverage
|PREVENTIVE DENTAL SERVICES||BASIC DENTAL SERVICES||MAJOR DENTAL SERVICES|
|Oral examinations||Simple, uncomplicated tooth extractions||Root canals|
|Teeth cleaning||Tooth fillings||Crowns and bridges|
|Permanent teeth sealants||White or tooth-colored resin filling/tooth filling for 1 surface||Oral surgery|
|X-Rays||Periodontal (structures around the teeth) maintenance cleanings||Orthodontics (tooth and jaw irregularity services like braces, invisible aligners, and more)|
Note: The Aetna Dental® Direct Coverage examples listed above are not all-inclusive and are for reference only.
If you are reading this article because you are looking for a way to cover the cost of braces, you can choose major dental services or check affordable brands like the ones listed in our review of the top six options.
Aetna Dental Insurance Versus Aetna Dental Discount Plan: Which Is Better?
Aetna Dental® Direct insurance options and Aetna Vital Dental Savings℠ plans are certainly two different types of dental benefits. The insurance covers a portion of your costs while a dental savings plan/dental discount plan cuts a portion of the total costs for services in the form of a discount. There are several factors that determine which one is better. The biggest factor is you. If you have major teeth problems, gum issues, or even jaw troubles; the insurance is probably your best bet. For those that only need minor dental repairs or maintenance, the discount plan may be the best choice. Insurance tends to cover more of the total cost for major dental work, such as repairing overbites, gapping, or crookedness, and even getting dentures.
Comparison of Aetna Dental Insurance versus Aetna Dental Savings
AETNA DENTAL® DIRECT INSURANCE
AETNA VITAL DENTAL SAVINGS℠
Aetna Insurance Reviews: What Do People Think About It?
When it comes to Aetna dental insurance customer reviews, the verdict is somewhere in the middle. While some customers claim that they’ve had no problems with covering dental expenses, others have found it difficult to get Aetna to pay up. For the lower Aetna Dental review rating end of it, customers claim that Aetna won’t cover what is clearly specified in their insurance policy. Some have stated that they keep finding reasons to deny coverage, such as determining that the dental need is not necessary, asking for dental records, denying the doctor’s letter of necessity, and more. For the positive Aetna Dental reviews, customers state that the insurance covered good amounts of money for the dental services they needed or that they have never had any problems using the insurance. Just like any other product or brand review, you will find both negative and positive responses. There is not a company out there that only gets positive Aetna Dental insurance reviews. It’s perfectly normal. However, it does help to identify what was positive and what was not, so you can make an informed decision.
Aetna Pros and Cons: Is Aetna Dental Good?
Aetna dental insurance is just like other dental insurance companies when it comes to pros and cons. Every company will have them. Some may have more pros than cons while others will have more cons than pros, such as Aetna. Aetna has a huge network of Aetna Dental providers as long as you carry a PPO plan. The DMO Aetna Dental insurance plans have a good amount of participating dentists in the network, but the database appears to be incorrect often (based on the Aetna Dental Plan reviews we found online). This makes it difficult to find a primary dentist or a specialist that accepts the insurance. One thing that separates Aetna Dental® from the competition is their digital, online tools. You can fill out claim forms within your online account rather than deal with faxes, papers, or mail delays.
AETNA DENTAL INSURANCE PROS
AETNA VITAL DENTAL SAVINGS℠
DMO stands for Dental Maintenance Organization. Aetna DMO dental plans offer low premiums in exchange for higher costs. You must use an in-network provider in order to receive insurance coverage and you must set up a primary care dentist. If a specialist is needed, your preferred dentist will provide a referral so you can receive coverage for that too. Aetna’s DMO plans have no deductible and no maximum coverage limits.
PPO stands for Preferred Provider Organization. Aetna PPO plans also have in-network providers like the DMO plans except that you can use out-of-network providers and still get some benefits. There is a deductible plus maximum coverage limits for specific services. Premiums for PPO plans are higher than DMO plans.
You can browse in-network Aetna Dental providers at https://www.aetna.com/individuals-families/find-a-doctor.html
Most denials are provided with a reason for the denial. If you feel that the denial was wrongfully decided upon, simply provide the information needed for Aetna to reconsider their decision. You can submit papers online, mail them, or fax them to the appropriate office. Many times, you will need your doctor to send/resend files and data. In those cases, the dentist or dental specialist will handle the paperwork for you simply because you can’t since you don’t have the information that Aetna requires. There is no guarantee that Aetna will approve the claim.
For general Inquiries, enrollment questions, and billing information; call 855-83-SMILE. For member benefit questions and claims; call 877-238-6200. Customer service hours are Monday – Friday, 8 a.m. to 8 p.m., EST/EDT. If you need the corporate contact center that has no access to member accounts, call 1-800-US-AETNA (1-800-872-3862.)
You can access your dental insurance account from the web address listed on your membership card.
This Post Has One Comment
Getting Aetna to pay for a crown is like pulling teeth. Pun intended. Apparently their go-to is threatening not to pay unless the dentist submits full mouth xrays. The xray of the problem tooth isn’t enough. Full mouth xrays for one crown? Someone at Aetna needs to be replaced.