Published on April 14, 2023, Updated on April 19, 2023
Aetna Dental has the following Pediatric dental coverage plans available: Aetna dental direct preferred PPO, Aetna dental direct core PPO, and Aetna dental direct preventive PPO.
Aetna dental coverage plans for Pediatric Dentistry
Obtain the coverage you and your dependent require to maintain the health of your and your child’s mouths, teeth, and gums. You don’t need to have Aetna medical or other coverage with Aetna to purchase the Aetna Dental PPO plan because preventive oral care is fully covered with no out-of-pocket expenses.
Aetna Dental® Direct Preferred PPO
Aetna Dental® Direct Preferred PPO provides the highest level of coverage if you and your dependent need more than routine oral care. Get an estimate of 100% or full coverage for preventive dental services like oral exams, cleanings, full mouth x-rays, and sealants with no waiting period. Aetna Dental® Direct Preferred PPO covers an estimated 20% of basic dental services such as resin fillings and simple tooth extractions with a 6 month waiting period. Major dental services namely root canals and dental crowns are estimated to be 50% covered with a waiting period of 12 months.
Note that the waiting period will be waived if everyone enrolling in the plan has had dental insurance within the last 90 days; otherwise, everyone applying will need to complete the waiting period before services are covered.
Aetna Dental® Direct Core PPO
Aetna Dental® Direct Core PPO is the same as the Preferred plan with a lower monthly premium, but you may pay more for services. With Aetna Dental® Direct Core PPO, you and your child (dependent) can get an estimate of 100% coverage for preventive oral services such as dental exams, teeth cleanings, full mouth x-rays, and dental sealants with no waiting period. Aetna Dental® Direct Core PPO plan offers an estimated 50% coverage of basic oral care namely resin fillings and simple tooth extractions with a waiting period of 6 months. Major dental services like root canals and crowns are estimated to be 50% covered with a o12 month waiting period.
Keep in mind that the waiting period will be waived if everyone applying in the plan has had dental insurance within the last 90 days; or else, everyone enrolling will have to complete the waiting period before services are insured.
Aetna Dental® Direct Preventive PPO
Aetna Dental® Direct Preventive PPO is for the budget-conscious coverage for routine care with the lowest cost monthly premium. You and your child (dependent) can get an estimated full or 100% coverage for preventive oral services such as dental exams, teeth cleanings, full mouth x-rays, and dental sealants with no waiting period. There is no annual maximum benefit and no deductible for this plan.
Looking for a pediatric dentist that accepting Aetna Dental? We accept Aetna Dental.
Aetna dental covers Retainers after Braces for kids?
Aetna Dental may cover part of your child’s retainers depending on your and your dependent’s specific plan and coverage. Please see your plan documents for coverage details. Please give us a call to find out what might be covered for your child’s specific situation. Source
How much does Aetna Dental cover X-Rays for Children?
Aetna Dental covers an estimated 100% of bitewing x-rays for children once every year. Aetna dental plans also offer full coverage for full mouth x-rays in-network and an estimated 20% coverage for out-of-network. Members and their dependents can immeditely start using their benefits for preventive dental services. Source
Does Aetna Dental cover Cleaning and Tooth Fillings for Children?
Aetna dental offers an estimated 100% coverage for in-network teeth cleanings for children while an estimate of 20% coverage is provided for out-of-network young patients. Resin fillings for kids are estimated to be 20%-50% covered. The waiting period is waived if all registered family members or dependents received dental coverage within the previous 90 days. In-network and out-of-network dependents are both subject to the same deductible and yearly maximum payments. Deductible only applies to basic oral services such as fillings.
Are Frenectomy, Tongue Tie and Lip Tie covered by Aetna dental?
When infant feeding difficulties or childhood articulation issues are present, Aetna deems lingual or labial frenectomy and frenotomy medically necessary for ankyloglossia or tongue-tie. MetLife Dental may cover part of your child’s frenectomy, lip tie surgery, or tongue tie procedure depending on the specific PPO plan and coverage you and your dependent have. Please give us a call to find out what might be covered for your child’s specific situation.
For latest information, please visit: https://www.aetna.com/individuals-families/buy-dental-coverage.html for more details.
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 3/27/2023. The above logo & trademarks are property of Aetna Dental.