Aetna Dental PPO Insurance Orthodontics Coverage

Are you searching for an orthodontist in Erie, Colorado that accepts Aetna Dental PPO insurance? At Hardy Pediatric Dentistry & Orthodontics, we gladly accept Aetna Dental plans and can help you navigate your orthodontic benefits to maximize your coverage. Our team of specialists, led by Board-Certified Orthodontist Dr. T.C. Hardy, works with families to ensure affordable orthodontic care while delivering exceptional results.

Understanding Your Aetna Dental PPO Orthodontic Benefits

Navigating dental insurance coverage for orthodontic treatment can be confusing. Let’s break down what you need to know about Aetna Dental PPO plans and how they can help make your orthodontic treatment more affordable at our Erie practice.

Aetna Dental offers several PPO plans with varying levels of orthodontic coverage. Your specific benefits depend on whether you obtained your plan through an employer or purchased it independently. Each plan has different coverage percentages, lifetime maximums, and potential limitations for orthodontic services. Our insurance specialists at Hardy Pediatric Dentistry & Orthodontics can help verify your exact coverage and explain how it applies to your or your child’s treatment plan.

Before starting any orthodontic treatment, we recommend contacting Aetna using the number on your ID card to confirm your benefits. Alternatively, our team can help you understand your coverage and assist with maximizing your benefits to reduce your out-of-pocket expenses.

Aetna Dental PPO Plans Covering Orthodontics

Aetna Dental Preferred PPO

The Aetna Dental Preferred PPO plan provides the highest level of orthodontic coverage among Aetna’s offerings. This premium plan is ideal for families planning significant orthodontic treatment.

With the Preferred PPO plan, Aetna typically covers orthodontic treatment up to a $1,500 lifetime maximum per person. This coverage applies to both children and adults, making it a flexible option for families. The plan usually covers approximately 50% of orthodontic treatment costs, though exact percentages may vary based on your specific policy.

Even with this comprehensive coverage, certain limitations may apply regarding the types of orthodontic appliances covered. Our team at Hardy Pediatric Dentistry & Orthodontics will help you navigate these details to maximize your benefits for treatments like traditional braces, clear braces, or Invisalign.

Standard Aetna Dental PPO

The standard Aetna Dental PPO plan offers a more affordable monthly premium option while still providing valuable orthodontic coverage. This plan might be suitable for families seeking a balance between premium costs and benefits.

Under the standard PPO plan, Aetna typically provides up to $1,250 as a lifetime maximum per person for orthodontic treatment. Like the Preferred PPO, this coverage extends to both children and adults. While you’ll pay less in monthly premiums with this plan, you may have slightly higher out-of-pocket costs for orthodontic services.

The standard plan also carries certain limitations regarding covered appliances and treatments. Our experienced team will review your policy details to help you understand exactly what’s covered and how to minimize your expenses while achieving your smile goals.

Orthodontic Treatment Options Covered by Aetna Dental

Traditional Braces Coverage

Traditional metal braces remain one of the most common orthodontic treatments, and Aetna Dental PPO plans typically provide good coverage for this option. For patients under 19, these plans often cover approximately 50% of the cost of traditional braces up to the plan’s lifetime maximum.

Adults may also receive coverage for traditional braces, though some plans may have age restrictions or different coverage percentages. Our team can verify your specific benefits and explain how they apply to traditional braces treatment at our Erie office.

Some Aetna plans may have waiting periods before orthodontic coverage becomes active, particularly for new enrollees. We can help you determine if any waiting periods apply to your situation and plan accordingly.

Clear Braces Coverage

Clear ceramic braces offer a more aesthetically pleasing alternative to metal braces, and many patients prefer them for their less noticeable appearance. Aetna Dental PPO plans typically cover clear braces at the same rate as traditional braces—approximately 50% of the cost up to your lifetime maximum.

At Hardy Pediatric Dentistry & Orthodontics, Dr. T.C. Hardy offers high-quality clear braces that provide excellent results while being less visible than metal alternatives. The coverage for clear braces usually follows the same guidelines as traditional braces, with similar age considerations and possible waiting periods.

If you’re considering clear braces, our team can provide a detailed breakdown of your expected out-of-pocket costs after Aetna coverage is applied, helping you budget appropriately for your treatment.

Invisalign Coverage

Invisalign clear aligners have become increasingly popular for both teens and adults seeking a virtually invisible orthodontic treatment option. Aetna Dental PPO plans generally cover Invisalign treatment similarly to traditional braces, with most plans offering approximately 50% coverage up to a lifetime maximum of $1,250-$2,500, depending on your specific plan.

For Invisalign Teen, coverage often follows the same guidelines as adult treatment, though some plans may have different benefits for patients under 19. At Hardy Pediatric Dentistry & Orthodontics, we offer both Invisalign and Invisalign Teen treatments, and our insurance specialists can help determine your exact coverage for these options.

As with other orthodontic treatments, waiting periods and age restrictions may apply for Invisalign coverage. Our team will verify these details and help you maximize your benefits for this popular treatment option.

Lingual Braces Coverage

Lingual braces, which are placed behind the teeth for maximum discretion, are also covered by many Aetna Dental PPO plans. Coverage for lingual braces typically includes approximately 50% of the treatment cost, similar to other orthodontic options.

For patients under 19, lingual braces are often covered by Aetna dental insurance at the standard orthodontic rate. Adult coverage for lingual braces varies by plan, with some policies offering the same coverage as for younger patients.

The lifetime maximum and any waiting periods for lingual braces follow the same guidelines as other orthodontic treatments under your specific Aetna plan. Our team can verify these details and help you understand how they apply to lingual braces treatment at our practice.

Additional Orthodontic Services Covered by Aetna Dental

Retainers Coverage

After active orthodontic treatment is complete, retainers are essential for maintaining your new smile. Aetna Dental PPO plans may cover part of your retainer costs, typically as part of your overall orthodontic treatment rather than as a separate benefit.

Coverage for retainers varies by plan, with some policies including initial retainers within the orthodontic benefit and others treating them as a separate appliance. Replacement retainers may have different coverage guidelines or might not be covered at all, depending on your specific plan.

Our team at Hardy Pediatric Dentistry & Orthodontics will explain how your Aetna plan handles retainer coverage and help you understand any additional costs you might expect for this critical phase of treatment.

X-Rays and Diagnostic Coverage

Comprehensive orthodontic treatment begins with thorough diagnostics, including various types of x-rays. Most Aetna Dental PPO plans cover bitewing x-rays at 100% once per year when performed by in-network providers like Hardy Pediatric Dentistry & Orthodontics.

Full-mouth x-rays, which are often needed for orthodontic treatment planning, are typically covered at 100% when performed in-network. For out-of-network providers, coverage may drop to approximately 80%, resulting in some out-of-pocket costs.

Unlike some orthodontic benefits that may have waiting periods, diagnostic services like x-rays are usually available immediately upon plan activation. This allows you to begin the assessment process for orthodontic treatment right away, even if you need to wait before starting active treatment.

Frequently Asked Questions About Aetna Dental PPO Orthodontic Coverage

How do I know if my Aetna plan covers orthodontic treatment?

Your Aetna Dental PPO coverage for orthodontics depends on your specific plan. The easiest way to verify your orthodontic benefits is to contact Aetna directly using the customer service number on your insurance card. Alternatively, you can contact our office at (720) 764-6158, and our insurance specialists will help verify your coverage before your consultation. We’ll need your insurance information to check your specific benefits, including coverage percentages, lifetime maximums, and any applicable waiting periods or age restrictions. This information helps us create a personalized financial plan for your orthodontic treatment.

Does Aetna Dental cover orthodontic treatment for adults?

Yes, many Aetna Dental PPO plans provide orthodontic coverage for adults, not just children. However, the coverage details may differ between adult and pediatric treatment. Some plans offer the same coverage regardless of age, while others may have reduced benefits or different lifetime maximums for adult orthodontics. At Hardy Pediatric Dentistry & Orthodontics, we treat patients of all ages and can help adult patients understand their specific Aetna coverage. Dr. T.C. Hardy and Dr. Cierra Randall specialize in adult orthodontic treatment and will work with you to maximize your insurance benefits while achieving your smile goals.

How are orthodontic benefits typically paid out by Aetna?

Unlike regular dental procedures that are paid after each visit, orthodontic benefits through Aetna are usually distributed differently. Most Aetna plans pay orthodontic benefits in installments throughout your treatment rather than in one lump sum. Typically, a portion of your lifetime maximum is paid upfront when treatment begins, with the remainder distributed in quarterly payments throughout your active treatment period. This payment structure helps cover the ongoing costs of orthodontic care. Our financial coordinators at Hardy Pediatric Dentistry & Orthodontics will explain exactly how your benefits will be applied and help you plan for any remaining out-of-pocket expenses.

What if my orthodontic treatment costs exceed my Aetna lifetime maximum?

If your orthodontic treatment costs exceed your Aetna lifetime maximum (typically $1,250-$1,500 per person), you’ll be responsible for the difference. However, at Hardy Pediatric Dentistry & Orthodontics, we offer several options to make treatment affordable regardless of insurance limitations. We provide flexible payment plans with low or no interest to spread remaining costs over the duration of treatment. We also accept HSA and FSA funds, which allow you to use pre-tax dollars for orthodontic expenses. Additionally, we offer special discounts for payment in full and family members receiving treatment. During your consultation, we’ll create a complete financial plan that accounts for your insurance coverage and outlines any additional costs.

Can I use my Aetna Dental PPO at Hardy Pediatric Dentistry & Orthodontics?

Yes! Hardy Pediatric Dentistry & Orthodontics gladly accepts Aetna Dental PPO plans for both pediatric dentistry and orthodontic services. As an Aetna provider in Erie, Colorado, we work directly with Aetna to process claims and maximize your benefits. Our experienced team regularly works with Aetna plans and understands how to navigate their specific requirements and limitations. We’ll handle the insurance paperwork for you, making the process as smooth as possible. During your consultation, we’ll verify your coverage and provide a detailed breakdown of your expected out-of-pocket costs after insurance. Our goal is to make quality orthodontic care accessible and affordable for all families in Erie and surrounding communities.

Why Choose Hardy Pediatric Dentistry & Orthodontics for Your Aetna-Covered Treatment

At Hardy Pediatric Dentistry & Orthodontics, we combine exceptional clinical expertise with a patient-centered approach to care. Our practice features two board-certified specialists—Dr. Namrata Hardy for pediatric dentistry and Dr. T.C. Hardy for orthodontics—providing comprehensive care for your entire family under one roof.

Dr. T.C. Hardy is board-certified by the American Board of Orthodontics and brings award-winning expertise to every treatment plan. As an active member of numerous professional organizations, including the American Association of Orthodontists, he stays at the forefront of orthodontic advances to provide the most effective and comfortable treatment options.

Our practice offers a wide range of orthodontic treatment options covered by Aetna Dental PPO plans, including traditional braces, clear braces, Invisalign, InBrace lingual braces, and KLOwen custom braces. We utilize advanced technology like the iTero digital scanner, 3D printing, and CBCT imaging to ensure precise treatment planning and exceptional results.

Treatment Option Typical Aetna Coverage Available at Hardy Pediatric Dentistry & Orthodontics
Traditional Braces ~50% up to lifetime maximum
Clear Braces ~50% up to lifetime maximum
Invisalign ~50% up to lifetime maximum
Lingual Braces ~50% up to lifetime maximum
Retainers Partial coverage (varies by plan)
Diagnostic X-Rays 100% in-network (typically)

Schedule Your Aetna-Covered Consultation Today

Ready to start your journey to a healthier, more beautiful smile with your Aetna Dental PPO benefits? Our team at Hardy Pediatric Dentistry & Orthodontics is here to help you navigate your insurance coverage and create a treatment plan that fits your needs and budget.

  • Board-certified specialists in orthodontics and pediatric dentistry
  • Comprehensive orthodontic services for children and adults
  • Advanced technology for comfortable and efficient treatment
  • Flexible payment options to supplement insurance coverage
  • Convenient location serving Erie and surrounding communities

Don’t wait to achieve the smile you deserve. Contact us today to schedule your consultation and insurance verification.

📍 Visit Us: 3200 Village Vista Dr., Suite 110, Erie, CO 80516
📞 Call: (720) 764-6158
📩 Or Request an Appointment Online Today

DISCLAIMER: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information, please see the insurance company’s website or call the customer service or member services number listed on most insurance ID cards. Updated as of April 2025. The above logo & trademarks are property of Aetna Dental.