Aetna Medicare Advantage plans can provide coverage of dental care, and as one of the nation’s largest insurers, Aetna’s network of dental providers can be found scattered about the country in nearly every county.
To find an Aetna Medicare Advantage dentist near you, enter your zip code using the Find Aetna Medicare Health Care Professionals search tool. You can adjust the geographic range for which you would like to include in your search. If you would like to view a list of dental providers who accept a specific Aetna Medicare plan, choose “Select plan to find providers.” If you want to see a list of all dental providers in the chosen area who accept Aetna Medicare insurance, select “Skip plan selection.”
If you’re already an Aetna Medicare plan member, you can also print a list of Aetna Medicare dental providers or have Aetna send you a list by mail.
Aetna updates its directory of participating providers every day but Sunday, so the list of dental providers rendered can be trusted as accurate and complete. However, you may want to contact the chosen provider prior to scheduling an appointment or receiving care to confirm they still participate in Aetna’s network.
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Aetna Dental PPO Coverage
Original Medicare (Medicare Part A and Medicare Part B) provide very little coverage of dental care. Only in situations where you need emergency services, reconstructive oral surgery or dental care needed as part of surgery preparation will Original Medicare provide any coverage. Routine dental work like exams, cleanings and fillings are not covered.
But most Medicare Advantage plans (also called Medicare Part C) such as those offered by Aetna provide coverage for routine dental services including exams, teeth cleanings, fillings, X-rays, root canals, extractions, dentures and more. In fact, 97% of all Medicare Advantage plans in 2023 offer routine dental coverage.1
Using an Aetna Dental Provider
Your ability to use an Aetna Medicare dental provider will depend partly on the type of Medicare Advantage plan that you have.
- An HMO (Health Maintenance Organization) plan may restrict members to seeing only dental providers within the Aetna network of participants. Certain specialized dental services may require a referral. Preventive services like exams and cleanings are often covered at 100%.
- A PPO (Preferred Provider Organization) or HMO-POS (HMO Point-Of-Service) plan typically allows a little more freedom to seek dental care outside of the Aetna network and still receive some coverage under the plan. Like HMO plans, preventive services under these plans are often covered at 100% and you will pay nothing out of pocket when receiving care inside the Aetna network.
Aetna PPO, HMO, and HMO-POS plans will typically include a benefit maximum, which is a limit to the amount of dental care that the plan will cover in a given year.
Some Aetna Medicare plans use direct reimbursem*nt, which means you will pay for your dental care upfront and then submit a receipt for the services to Aetna for reimbursem*nt. You will be given an annual allowance to spend on dental care. There is no need to see only Aetna dental providers with plans that use direct reimbursem*nt. You are free to see any dental provider who accepts Medicare, even if they do not accept Aetna insurance.
If the Medicare Advantage plan itself does not include dental coverage, you may be able to acquire dental coverage through supplemental benefits, the cost of which are added to your monthly premium for a typically low fee.
Certain dental services may require prior authorization from Aetna, which means Aetna Medicare must approve the service before the plan will cover it. The dental provider is responsible for contacting Aetna to seek out prior authorization when needed.
Emergency Dental Care with Aetna Medicare Plans
Aetna Medicare Advantage plans provide coverage of emergency services anywhere in the world regardless of whether or not the care is provided by an Aetna dental provider.
Aetna Medicare Prescription Drug Coverage
Sometimes dental work may require your doctor to prescribe drugs for you, and prescription medication is an area not typically covered by Original Medicare. Thankfully, most Aetna Medicare Advantage plans offer prescription drug coverage.
You may see a directory of pharmacy locations that accept Aetna Medicare plans by using the Aetna Find a Pharmacy tool.
Benefits of Aetna Medicare for Dental Care
Because Original Medicare offers no coverage of routine dental care, two out of every three Original Medicare beneficiaries have no dental coverage.
One in five individuals on Medicare who seek dental care in a given year spend more than $1,000 out of pocket. 94% of people with Medicare Advantage plans have access to dental coverage.2
Proper dental care is a critical part of aging healthy as evidence suggests a link between oral health and overall health.
Aetna Dental Provider Phone Number
To learn more about the specific dental benefits, call Aetna Dental Member Services for more information. The Toll-free number is:
1-866-409-0937 (TTY:711) Monday to Friday, 9 AM to PM ET
