Aetna's managed dental plans cover a full range of preventive and restorative services to treat most aspects of dental disease. Benefits are available for a specific list of covered services, subject to plan provisions, including all limitations and exclusions.
See Dental Procedure Guidelines
Due to the continued development of new dental materials and equipment/technology, there are often many ways to treat dental conditions. Some of these involve the multitude of new restorative materials and prosthetic procedures being introduced to the marketplace, many of which are purely cosmetic in nature. Additionally, there are now alternative and enhanced techniques to render certain services with new technology, although the underlying procedure remains unchanged.
Often these are not addressed in the ADA Procedure Codes and Nomenclature. The DMO Dental Office Guide provides guidance for determining benefits in situations where the Primary Care Dentist and the patient are considering optional treatment plans involving elective services.
Whenever cosmetic procedures or enhanced technology are employed, the patient must be fully advised as to those procedures that are covered by the plan and those that are optional, so that an informed choice can be made. As with other noncovered services, if the patient elects to receive the services, then the patient is responsible for the cost of the additional procedures or materials. The total amount due from the patient is determined by establishing the copayment, if any, for the underlying covered service plus the incremental charge for the cosmetic procedures/materials or enhanced technology.
An informed consent form has been designed for your use. This form, or an equivalent, must be completed and signed by the DMO patient and the dentist prior to beginning treatment for optional treatment plans involving cosmetic services or enhanced technology/materials.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies (Aetna). Dental benefits and dental insurance plans are underwritten by Aetna Dental Inc., Aetna Dental of California Inc., and Aetna Health Inc. and/or Aetna Life Insurance Company (Aetna). In Texas by Aetna Dental Inc. and in Virginia, the DMO plan is known as the Dental Network Only plan (DNO). DNO in Virginia is not an HMO. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with network providers. Each insurer has sole responsibility for its own products.
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