Are you looking for exceptional pediatric dental care in Erie, CO that accepts Aetna Dental PPO insurance? At Hardy Pediatric Dentistry & Orthodontics, we’re proud to partner with Aetna to provide your child with top-quality dental care while maximizing your insurance benefits. Understanding your dental insurance coverage is crucial for making informed decisions about your child’s oral health.
Our team of pediatric dental specialists, led by board-certified Dr. Namrata Hardy, works directly with Aetna to ensure a seamless insurance experience. We’ll help you navigate your benefits so you can focus on what matters most – your child’s healthy smile.
In this comprehensive guide, we’ll explore everything you need to know about Aetna Dental PPO coverage for pediatric dentistry, from specific plan benefits to coverage details for common pediatric dental procedures.
Understanding Aetna Dental PPO Plans for Children
Aetna offers several dental PPO plans designed to provide comprehensive coverage for children’s dental needs. Each plan varies in terms of coverage levels, waiting periods, and monthly premiums, allowing you to choose the option that best fits your family’s needs and budget.
These PPO plans give you the flexibility to visit any dentist, but you’ll typically enjoy greater cost savings when you choose an in-network provider like Hardy Pediatric Dentistry & Orthodontics. With our in-network status, we can provide more accurate benefit information and help maximize your coverage.
One of the major advantages of Aetna Dental PPO plans is that you don’t need to have Aetna medical coverage to purchase a dental plan. This makes it easier for families to obtain quality dental coverage regardless of their medical insurance situation.
Aetna Dental® Direct Preferred PPO: Premium Coverage for Children
The Aetna Dental® Direct Preferred PPO plan offers the highest level of coverage for children who need more than just routine dental care. This comprehensive plan is ideal for families seeking maximum coverage for a wide range of pediatric dental services.
With this plan, your child receives 100% coverage for preventive services with no waiting period, including:
- Regular dental exams
- Professional teeth cleanings
- Full mouth x-rays
- Dental sealants to prevent cavities
For basic dental services such as resin fillings and simple tooth extractions, the Preferred PPO plan covers approximately 20% after a 6-month waiting period. Major dental procedures like root canals and dental crowns receive approximately 50% coverage after a 12-month waiting period.
It’s important to note that the waiting period may be waived if everyone enrolling in the plan has had dental insurance within the last 90 days. This feature makes the Preferred PPO plan an excellent option for families who are switching from another dental insurance provider.
Aetna Dental® Direct Core PPO: Balanced Coverage Option
The Aetna Dental® Direct Core PPO plan offers similar benefits to the Preferred plan but with a lower monthly premium. While you’ll pay less each month, out-of-pocket costs for services may be slightly higher compared to the Preferred plan.
With the Core PPO plan, your child still receives 100% coverage for preventive services with no waiting period, including:
- Dental examinations
- Teeth cleanings
- Complete x-rays
- Protective dental sealants
For basic dental services like resin fillings and simple extractions, this plan provides approximately 50% coverage after a 6-month waiting period. Major dental procedures such as root canals and crowns also receive approximately 50% coverage, but with a longer 12-month waiting period.
Just like with the Preferred plan, the waiting period for the Core PPO can be waived if all family members enrolling have had dental insurance within the past 90 days. This makes transitioning to Aetna more convenient for families with existing dental coverage.
Aetna Dental® Direct Preventive PPO: Affordable Preventive Care
For families primarily focused on preventive care with budget-friendly premiums, the Aetna Dental® Direct Preventive PPO plan offers an excellent option. This plan features the lowest monthly premium while still providing robust coverage for essential preventive services.
With the Preventive PPO plan, your child receives 100% coverage for all preventive dental services with no waiting period, including:
- Regular dental check-ups
- Professional teeth cleanings
- Comprehensive x-rays
- Protective sealants
A significant advantage of this plan is that there’s no annual maximum benefit and no deductible. This means your child can receive all covered preventive care throughout the year without worrying about reaching coverage limits or paying initial out-of-pocket costs.
While this plan doesn’t cover basic or major dental services, it provides an affordable way to maintain your child’s dental health through regular preventive care, which is crucial for avoiding more serious dental issues in the future.
Specific Pediatric Dental Procedures Covered by Aetna
X-Ray Coverage for Children
Diagnostic imaging is essential for detecting and preventing dental problems in children. Aetna Dental provides generous coverage for pediatric x-rays, with approximately 100% coverage for bitewing x-rays once per year for children.
Full mouth x-rays receive approximately 100% coverage when performed by in-network providers like Hardy Pediatric Dentistry & Orthodontics. For out-of-network providers, coverage is typically around 20%. The good news is that members and their dependents can immediately start using their benefits for preventive services, including x-rays, with no waiting period.
At Hardy Pediatric Dentistry, we use state-of-the-art digital x-ray technology that reduces radiation exposure by up to 90% compared to traditional x-rays. This technology allows us to provide safer, faster, and more accurate diagnostic imaging for your child.
Cleanings and Fillings for Children
Professional teeth cleanings are fundamental to maintaining your child’s oral health. Aetna Dental offers approximately 100% coverage for in-network cleanings for children, while out-of-network cleanings typically receive around 20% coverage.
For resin fillings, which are often needed to treat cavities in children, Aetna plans provide between 20% and 50% coverage depending on your specific plan. It’s worth noting that both in-network and out-of-network dependents are subject to the same deductible and yearly maximum payments, with the deductible only applying to basic services like fillings.
At Hardy Pediatric Dentistry, we offer innovative laser dentistry techniques that can often treat cavities without the need for drills or shots. This advanced approach makes the filling process more comfortable for children while still being covered by your Aetna dental plan.
Orthodontic Retainers for Children
Many children require orthodontic treatment, and retainers are an essential part of maintaining the results. Aetna Dental may cover a portion of your child’s retainers, depending on your specific plan and coverage details.
Coverage for orthodontic retainers varies significantly between plans, so we recommend reviewing your plan documents for specific details. Our experienced team at Hardy Pediatric Dentistry & Orthodontics can help determine what might be covered for your child’s specific situation.
With our in-house orthodontist, Dr. T.C. Hardy, we offer comprehensive orthodontic care including retainer fitting and adjustments. This integrated approach ensures that your child’s dental and orthodontic needs are addressed under one roof, making it more convenient to coordinate insurance coverage.
Frenectomy, Tongue Tie, and Lip Tie Procedures
Aetna considers lingual or labial frenectomy and frenotomy medically necessary for ankyloglossia (tongue-tie) when infant feeding difficulties or childhood articulation issues are present. These procedures may be partially covered depending on your specific PPO plan and coverage.
At Hardy Pediatric Dentistry, Dr. Nam specializes in infant and child frenectomy using the advanced LightScalpel laser technology. This minimally invasive approach offers faster healing and less discomfort compared to traditional techniques.
If your child requires a frenectomy, tongue tie, or lip tie procedure, we recommend contacting our office to verify your coverage details. Our experienced team can help determine what portion of the procedure might be covered under your Aetna dental plan.
How to Maximize Your Aetna Dental Benefits at Hardy Pediatric Dentistry
To get the most from your Aetna Dental PPO insurance, consider these helpful tips:
- Schedule regular preventive visits: Since preventive care is covered at 100% with no waiting period across all Aetna plans, make sure to schedule your child’s regular check-ups and cleanings every six months.
- Coordinate treatment timing: If your child needs basic or major dental work, coordinate with our office to plan treatment after any applicable waiting periods have ended (unless you qualify for a waiting period waiver).
- Verify coverage before treatment: Our team can help verify your specific coverage before any procedure, giving you a clear understanding of potential out-of-pocket costs.
- Consider treatment phasing: For extensive dental work, we can help phase treatment across calendar years to maximize annual benefits if applicable to your plan.
- Ask about alternative treatments: In some cases, we may be able to recommend alternative treatments that provide excellent care while being more favorably covered by your insurance.
Why Choose Hardy Pediatric Dentistry & Orthodontics for Your Child’s Dental Care
When selecting a pediatric dentist that accepts Aetna Dental PPO insurance, Hardy Pediatric Dentistry & Orthodontics offers several unique advantages:
| Benefit | What This Means for Your Child |
| Board-Certified Specialists | Dr. Nam is a Diplomate of the American Board of Pediatric Dentistry with specialized training in children’s dental needs |
| Advanced Laser Dentistry | No shots, no drills for many procedures, making dental visits less stressful |
| Comprehensive Care | Both pediatric dentistry and orthodontics under one roof for coordinated care |
| In-Network Provider | Maximize your Aetna benefits with our in-network status |
| Child-Focused Environment | Office designed specifically for young patients’ comfort and needs |
Dr. Namrata Hardy specializes in pediatric dentistry, with additional training specifically focused on the unique dental needs of infants, children, and adolescents. Her gentle approach helps children feel comfortable and develop positive associations with dental care.
Our practice also offers orthodontic services with Dr. T.C. Hardy, allowing for seamless coordination between pediatric and orthodontic care. This integrated approach ensures that all aspects of your child’s oral health are addressed cohesively.
Frequently Asked Questions About Aetna Dental Coverage
Does Aetna Dental cover pediatric dental emergencies?
Yes, Aetna Dental PPO plans typically provide coverage for pediatric dental emergencies, though coverage levels vary by plan. The Preferred and Core PPO plans generally cover emergency visits at the same rate as other basic or major services, depending on the treatment needed. At Hardy Pediatric Dentistry, we offer emergency appointments for children experiencing dental pain, trauma, or other urgent dental issues. We’ll work with your Aetna insurance to ensure proper coverage for emergency care.
Are space maintainers covered under Aetna Dental plans?
Most Aetna Dental PPO plans provide partial coverage for space maintainers, which are often necessary when a child loses a baby tooth prematurely. Space maintainers help preserve the space for the permanent tooth to emerge properly. Coverage typically ranges from 20-50% depending on your specific plan, and our office can help verify your exact coverage for this important preventive orthodontic treatment. Dr. Nam and Dr. Hardy work together to ensure proper space maintenance for developing smiles.
Does Aetna Dental cover sedation for anxious children?
Aetna may provide partial coverage for sedation or anesthesia when deemed medically necessary for pediatric dental procedures. Coverage depends on your specific plan and the type of sedation used. At Hardy Pediatric Dentistry, we offer various comfort options for anxious children, including nitrous oxide (laughing gas) and other sedation methods when appropriate. Our team can help determine what portion of sedation services might be covered under your Aetna plan before treatment.
How often will Aetna cover fluoride treatments for children?
Most Aetna Dental PPO plans cover fluoride treatments for children up to age 19 once or twice per year, depending on your specific plan. Fluoride treatments are typically covered at 100% as part of preventive care with no waiting period. These treatments are essential for strengthening enamel and preventing cavities in developing teeth. Dr. Nam recommends regular fluoride applications as part of a comprehensive preventive care approach for children.
Can I use my Aetna Dental benefits for my child’s sports mouthguard?
Some Aetna Dental PPO plans provide partial coverage for custom-fitted sports mouthguards, especially when prescribed for children who participate in contact sports. Coverage typically ranges from 20-50% depending on your specific plan. At Hardy Pediatric Dentistry, we create custom-fitted mouthguards that provide superior protection compared to over-the-counter options. These custom guards are more comfortable, allowing for easier breathing and communication during sports activities while providing maximum protection against dental injuries.
Ready to Schedule Your Child’s Appointment?
At Hardy Pediatric Dentistry & Orthodontics, we’re committed to providing exceptional dental care for your child while helping you maximize your Aetna Dental PPO benefits. Our friendly staff will work with you to verify coverage, explain benefits, and ensure you understand any potential out-of-pocket costs before treatment.
For the latest information on Aetna Dental plans, please visit: https://www.aetna.com/individuals-families/buy-dental-coverage.html.
📍 Visit Us: 3200 Village Vista Dr., Suite 110, Erie, CO 80516
📞 Call: (720) 764-6158
📩 Or Request an Appointment Online Today
