Select a state below to update coverage details. Aetna Inc. and itsaffiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Claims must be submitted within 365 days of the date you received the service. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Whether youre at your desk or on the go, our easy-to-use digital tools help you manage your dental plan, save money and make smart decisions about your care. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. For which you have no legal obligation to pay. Network dentists also file claims for you. Plan 41 Effective Date: 01-01-2022 Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Massachusetts license number: 10041444. What does the Aetna Dental PPO Plan cover? Copyright 2015 by the American Society of Addiction Medicine. ***Certain brands impose a no-discount policy. Your dental plan may have yearly and lifetime limits on coverage. This is donethrough an optional supplemental benefit. Your InstaMed log in may be different from your Caremark.com secure member site log in. Visit the secure website, available through www.aetna.com, for more information. Thats it. So your share of the cost is usually lower. Aetna makes no payment to the third parties you are responsible for the full cost. Links to various non-Aetna sites are provided for your convenience only. The EOC is the legal contract between you and the Medicare plan. For PPO plans and most HMO-POS plans, you have the option to go to any licensed provider, but could save money by using a provider in the network. See the insurance policy for details. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. Most plans also have a benefit maximum, a limit on the amount the plan will pay out to cover dental services. Find the right plans and programs for you. 4. . CPT is a registered trademark of the American Medical Association. Aetna 2022 Medicare plans feature more benefits, lower member costs and Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Spirit Dental & Vision is a nationwide carrier that offers a range of PPO dental insurance plan. 2022 A Nationwide Dental PPO Plan IMPORTANT Rates: Back Cover Changes for 2022: Page 4 . Aetna Dental has over 50 years of experience offering dental benefits. **Through the ChooseHealthy program, which is provided by ChooseHealthy, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. With Aetna Dental Direct, youll get the coverage you need to keep your teeth healthy. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. 2022 Aetna Medicare Choice Plan (PPO) in Santa Fe, New Mexico The three carriers providing service to the District's employees are CompBenefits/Humana (Basic and Enhanced PPO/Indemnity and DHMO Managed Care), Aetna (Basic and Enhanced PPO/Indemnity), and Aetna (Basic and Enhanced DHMO Managed Care). Aetna Direct Core PPO comes with lower premiums, and Direct Preferred PPO provides more favorable splits in payment for basic procedures like fillings and extractions. Cigna DPPO plan features 1. If you do not intend to leave our site, close this message. Enrollment in our plans depends on contract renewal. How to enroll: Get savings on weight-loss programs and meal plans, and enjoy one-on-one help, personalized menus, online tools and chat rooms. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The AMA is a third party beneficiary to this Agreement. With adirect member reimbursementallowance, youre givena set amount of money to spend each year on dental care.. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies.

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