Aetna Medicare Advantage plans match the coverage of Original Medicare and offer additional benefits, including dental care.
Some plans cover preventive care, and others extend coverage to comprehensive care, such as fillings and extractions.
Medicare is a federal government program, and people can access Medicare benefits through either Original Medicare (Parts A and B) or a Medicare Advantage plan from a private insurance company, such as Aetna.
This article discusses Aetna Medicare Advantage plans and dental care coverage. It also looks at eligibility for Aetna plans and some of the costs.
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Aetna began in 1853 in Hartford, CT. CVS Health acquired the company in 2018, and Aetna currently serves the health needs of about 39 million people.
Aetna provides medical, prescription drug, and dental insurance plans, including Medigap and Medicare Advantage plans. The company’s Advantage plans include:
Each year, the Centers for Medicare & Medicaid Services (CMS) rate Medicare Advantage plans using a star rating system. Based on quality and customer satisfaction, the CMS awarded a rating from 1 to 5 stars. They awarded Aetna’s 2021 plans an average of 4.5 out of 5.0 stars.
Aetna Medicare Advantage plans offer additional benefits that Original Medicare does not provide. These benefits may include coverage for dental care, including:
The specific details of each plan vary, and some plans are more comprehensive than others. People can check their plan’s Evidence of Coverage for the details of dental coverage.
The Medicare plan finder can also help a person get more information about Advantage plans.
If an Aetna Medicare Advantage plan provides dental benefits, the plan’s monthly premium may cover the cost of these services. In other cases, a person may need to purchase an optional supplemental benefit and pay an additional monthly premium.
Aetna also offers a stand-alone dental direct plan, which offers preventive care with zero out-of-pocket costs.
Aetna Advantage plans provide dental benefits through either the Aetna network or direct member reimbursement (DMR).
This online tool can help a person find providers that accept their Advantage plan.
With a network plan, the member must use an approved dentist from a named network who has a contract with Aetna.
The company’s in-network plans cover the total cost of preventive care, which includes:
Some Aetna Advantage plans include extensive services, such as fillings and extractions.
If an Aetna Medicare Advantage plan offers dental coverage through DMR, a person pays upfront when they get the dental care and then submits an itemized receipt. Aetna provides forms that the person needs to complete, and the company then reimburses the amount up to the plan allowance.
People can use any licensed dental care provider in the United States for Aetna-approved services, providing that they accept Medicare.
DMR plans include coverage for most preventive care and other comprehensive services.
All Medicare Advantage plans, including Aetna’s offerings, have associated costs.
Plan costs vary. For example, the Aetna Medicare Value HMO Plan has the following associated costs for 2024:
The plan has a separate deductible for certain types of services, including dental care. Until the beneficiary has paid the deductible amount, they must pay the full cost. After that, the costs will be:
The plan pays up to $2,500 annually for dental services. An individual must pay any amount above this limit for the dental care they receive.
Aetna also offers a discount card that provides savings of 15% to 50% off the cost of many dental services.
To join an Aetna Medicare Advantage plan, people must qualify for enrollment in Original Medicare.
Generally, U.S. citizens or permanent legal residents meet the requirements for Original Medicare when they reach the age of 65 years old. A person may also qualify if they are under 65 years of age and, for the last 2 years, have received Social Security disability benefits or a disability pension from the Railroad Retirement Board.
If someone has end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), they may also qualify for enrollment, although they may need to select an SNP. These plans cater specifically to people with certain health conditions.
There are various enrollment periods during which people can join, change, or cancel their Medicare plans, including Advantage plans.
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Aetna Medicare Advantage plans provide benefits that Original Medicare does not. These typically include some level of dental coverage, including twice-yearly oral health exams, teeth cleaning, and X-rays, if necessary.
The level of dental coverage and the associated costs vary among Aetna plans.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
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© 2024 Healthline Media UK Ltd, Brighton, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.
