What is generally covered under an Aetna dental plan?


Quick Answer

Aetna dental plans generally cover composite routine checkups, cleanings, X-rays, fillings and tooth replacement, according to Aetna. Oral surgery and orthodontic treatment are extra benefits, depending on the type of plan.

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Full Answer

Orthodontic coverage is generally effective only after coverage begins, because some plans have a work-in-progress exclusion, states Aetna. However, some other plans do cover a member who has orthodontic treatment in progress by a different plan before switching to the Aetna dental plan. The coverage amount depends on the amount paid and the number of months remaining in the previous course of treatment. A previous plan that has ended has no benefits. Coverage can extend up to the lifetime plan maximum, as long as treatment starts after the plan begins.

Aetna defines oral surgery as either dental in nature or medical in nature, explains Aetna. Dental surgery involves the tooth and is covered by Aetna dental plans. Medical surgery, such as facial bone disease, hard and soft tissue trauma in the face and oral cavity, treatment of jaw disorder, and correcting of facial deformities are covered under a medical plan.

A student dependant who is at least 19 years old is eligible for coverage if he has no full-time job and regularly attends school on a full-time or part-time basis, states Aetna. Disabled dependants are eligible, but must pass certain criteria.

Types of dental plans available from Aetna are Dental Maintenance Organization, or DMO, plans; Preferred Provider Organization, or PPO, plans; and Participating Dental Network, or PDN, plans.

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