Aetna FAQs: Answers on Dental, Vision, Networks and Marketplace Changes
These Aetna FAQs answer the questions people ask most about Aetna dental, vision and marketplace changes. Licensed Vivna agents wrote every answer in plain English. So you can see how its plans, networks and costs really work. Call 888-730-6001 anytime for free help.
Vivna Insurance is an independent, licensed agency offering Aetna individual dental and vision insurance products. Plans, benefits, and availability vary by state.
Aetna Basics
A famous name still raises questions. So start here to see what Aetna offers through Vivna today.
β What is Aetna?
A national health insurer founded in Hartford, Connecticut, and now part of CVS Health.
Aetna has served members since the 1800s. Today, it sells employer, Medicare, dental and vision coverage.
Through Vivna, Aetna options center on individual dental and vision plans. So start with our Aetna carrier guide.
β Is Aetna part of CVS Health?
Yes. Aetna is a CVS Health company.
That link brings perks to some plans. For example, many Aetna dental plans include CVS ExtraCare Plus.
The perks vary by plan and state. So ask us which ones apply to you.
β What does Aetna offer through Vivna?
Individual dental PPO plans, dental DMO plans and vision plans.
Dental plans come in three PPO levels, plus a DMO in many areas. Meanwhile, vision plans come in Value, Select and Elite tiers.
You can also add vision to a dental PPO plan. So compare all your choices on our dental and vision page.
β Can I still buy Aetna health insurance for my family?
Not on the ACA marketplace. Aetna no longer sells individual marketplace plans.
Former Aetna members had to choose new medical coverage. Thankfully, strong replacement plans exist in most areas.
We compare Ambetter, Oscar, UnitedHealthcare and more. Then see our health insurance plans.
β Is Aetna a good dental insurance company?
Yes. It runs one of the largest dental networks in the country.
Large networks make it easier to keep your dentist. Plus, individual plans skip the employer middleman.
Still, the best plan depends on your needs. So we compare Aetna with other carriers at 888-730-6001.
β Does Vivna sell Aetna Medicare plans?
No. The Aetna options at Vivna are individual dental and vision plans.
Aetna sells Medicare plans directly and through other agents. Meanwhile, we focus on individual health, dental, vision and supplemental coverage.
Older adults can still add an Aetna dental or vision plan. So call 888-730-6001 to see what fits.
β I have Aetna through work. Can Vivna help?
Yes, especially if you leave that job or lose coverage.
Job-based Aetna plans end when employment ends. Then COBRA or a new individual plan can fill the gap.
We compare both paths for free. Also, read COBRA vs. marketplace coverage.
β Why buy Aetna dental through Vivna?
Free licensed help plus side-by-side comparisons with other carriers.
We quote Aetna beside UnitedHealthcare, Cigna and Aflac. Then the best value wins your application.
Prices match whether you buy direct or through us. Also, learn why agents matter.
β Who is Aetna dental a good fit for?
Individuals and families without job-based dental coverage.
Self-employed workers and early retirees often fit best. Also, families can cover children on the same plan.
Your dentist and budget decide the final choice. Also, read how to choose dental and vision coverage.
β How do I enroll in an Aetna dental or vision plan?
Call a licensed Vivna agent, and we will quote and enroll you.
We check your dentist, compare levels and submit the application. Then your ID card arrives by mail.
An application is required for every plan. So call 888-730-6001, or request a free quote.
Aetna Availability and the ACA Marketplace
Aetna changed how it sells individual coverage. So here is where its plans stand today.
β Did Aetna leave the ACA marketplace?
Yes. Aetna CVS Health stopped selling individual marketplace health plans.
About one million members across 17 states needed new medical coverage. Most moved to other marketplace carriers.
If that included you, we can review your new plan. Also, see our open enrollment guide.
β I was an Aetna marketplace member. What should I do now?
Compare plans each open enrollment so your coverage still fits.
Your replacement plan may have new prices or networks. Therefore, a yearly review protects your budget.
We compare every carrier in your county. Also, read why to review coverage each year.
β Which carriers replaced Aetna marketplace plans?
It depends on your county, but options often include Ambetter, Oscar and UnitedHealthcare.
Molina and Blue Cross Blue Shield plans sell in many areas too. Meanwhile, tax credits still apply on every marketplace plan.
We show your local options side by side. Then visit our Ambetter and Oscar guides.
β Can I switch health plans outside open enrollment?
Only with a qualifying life event, like moving or losing coverage.
Losing a plan often opens a special enrollment period. Otherwise, you wait for open enrollment.
Dental and vision plans follow different rules. So read buying after open enrollment.
β When can I buy Aetna dental insurance?
Any time of year. Individual dental plans have no open enrollment window.
You can apply today and pick a start date. However, waiting periods apply on some services.
Buying sooner starts those clocks sooner. So call 888-730-6001 to begin.
β Is Aetna dental sold in my state?
It sells in most states, with plans and prices that vary by location.
A few states, like Louisiana and Utah, do not offer these individual plans. Also, DMO plans may not reach every ZIP code.
One call confirms your options. Also, visit our state coverage hub.
β Is Aetna vision available everywhere?
In most states, though the add-on vision plan skips a few.
The vision add-on is not sold in Illinois, Kansas, Massachusetts, Missouri, New York, Virginia or Washington. Stand-alone vision plans may still be available.
Rates and benefits vary by location. So we check your ZIP code at 888-730-6001.
β Where are CVS ExtraCare Plus perks included?
β What happens to my Aetna dental plan if I move?
Tell us right away, since plans and prices vary by state.
Some plans may not follow you to a new state. In that case, we help you find a replacement.
Moving can also open a special enrollment period for health coverage. Also, read life events and coverage.
β Where can Vivna help with Aetna plans?
In the states where Vivna is licensed and Aetna sells individual plans.
Vivna is licensed in 48 states. Therefore, most families can get help from our team.
Not sure about your state? Then call 888-730-6001 for a quick check.
Aetna Dentist and Eye Doctor Networks
Networks decide what you pay at each visit. So here is how Aetna networks work for dental and vision.
β What dental network do Aetna plans use?
The Aetna Dental network, one of the largest in the country.
PPO plans let you see network or non-network dentists. However, network dentists charge lower, agreed prices.
DMO plans use the network only, except emergencies. Also, read about in-network vs. out-of-network costs.
β How do I find an Aetna dentist?
Search Go.Aetna.com/Dental, or call 1-877-238-6200.
Filter by ZIP code and plan type. Then confirm with the office before your visit.
Also, our Find a Doctor page links every carrier search. We can also check for you.
β Can I keep my current dentist with Aetna?
Often yes, if your dentist is in network or you choose a PPO.
PPO plans pay toward non-network dentists, at lower levels. By contrast, DMO plans need a network dentist.
Always check before you enroll. Also, read how to find an in-network dentist.
β What happens if I see an out-of-network dentist?
Your plan pays less, and the dentist may bill you the difference.
Non-network dentists can balance bill above the plan allowance. As a result, your costs can climb quickly.
Annual maximums also run lower out of network. So see how network costs compare.
β What vision network does Aetna use?
The Aetna Vision network, administered by EyeMed.
It includes independent eye doctors and major retail chains. Many locations offer evening and weekend hours.
Then search providers by ZIP code at AetnaVision.com. Or let us check for you at 888-730-6001.
β Can I use Aetna vision benefits online?
Yes. Retailers like Glasses.com and LensCrafters.com apply benefits at checkout.
CVS.com/optical accepts benefits too. That way, you can shop from home.
Online orders still follow your allowance limits. Also, read how vision benefits work.
β Are dental emergencies covered anywhere?
Yes. Emergency care to relieve pain is covered 24/7.
Network emergency visits follow a set fee schedule. Meanwhile, out-of-network emergencies may cost you the difference.
Keep your ID card handy for urgent visits. Also, see how to read your insurance card.
β What if my dentist leaves the Aetna network?
You can switch dentists, or pay out-of-network rates on a PPO.
DMO members must choose a new primary dentist. Meanwhile, PPO members can stay at a higher cost.
So we help you weigh both paths. Read what to do when a doctor leaves your network.
β Can I see a dental specialist with Aetna?
Yes. PPO members can go directly, while DMO members need a referral.
Specialists include oral surgeons, endodontists and periodontists. Still, coverage levels follow your plan schedule.
Ask for a pre-treatment estimate before big work. Then you will know your share.
β How do I confirm a provider before my visit?
Call the office with your plan name and member ID.
Directories can lag behind real changes. So a quick call prevents surprise bills.
Also, read how to check if a doctor is in network. Or call us at 888-730-6001.
Aetna Dental PPO Coverage
Aetna dental PPO plans share costs in three levels. So here is how deductibles, maximums and waiting periods work.
β What Aetna dental PPO plans can I buy?
Direct Preferred 2000 PPO, Direct Preferred PPO and Direct Core PPO.
Each plan covers preventive, basic and major care at different levels. Also, higher plans carry bigger annual maximums.
Plan details can vary by state. So compare them on our dental insurance page.
β What is the Aetna dental PPO deductible?
$50 per person or $150 per family each calendar year.
It applies to basic and major services only. Meanwhile, preventive care skips the deductible entirely.
The deductible counts in and out of network together. Also, read how deductibles work.
β What are the Aetna dental annual maximums?
$2,000, $1,250 or $1,000 in network, depending on the plan.
Out-of-network maximums run $250 lower on each plan. After you reach the cap, you pay the rest.
Big treatment plans can hit the cap fast. Therefore, spreading work across plan years can help.
β Are cleanings free with Aetna dental?
Yes. In-network exams, cleanings and X-rays cost you nothing.
Out of network, you pay 20% of preventive care. Molar sealants also count as preventive.
Two checkups a year catch problems early. Also, read our dental care coverage guide.
β How much do I pay for fillings with Aetna?
20% in network on Preferred plans, or 50% on Core.
Basic care includes fillings, simple extractions and periodontal maintenance. A six-month waiting period usually applies.
Out-of-network shares run higher. So ask us for a side-by-side quote at 888-730-6001.
β How much do I pay for crowns or root canals?
About 50% in network after a 12-month waiting period.
Major care includes crowns, root canals, oral surgery and dentures. Out of network, you pay 60% to 70%.
Ask your dentist for a pre-treatment estimate first. Then compare plan levels with us.
β Can Aetna waive dental waiting periods?
Yes, if everyone enrolling had dental coverage in the past 90 days.
Proof of prior coverage removes the waits. That way, basic and major care start sooner.
Gaps longer than 90 days restart the clock. So switch plans without a break.
β Does Aetna individual dental cover braces?
No. These individual plans do not cover orthodontics.
Braces and aligners stay excluded on PPO and DMO plans. Instead, look for a plan with orthodontia benefits.
Some carriers include braces after a waiting period. Also, read about coverage for kids.
β Are dental implants covered by Aetna?
No. Implants are excluded on these individual plans.
Cosmetic work, like whitening, is excluded too. However, dentures and bridges may be covered under major care.
Special replacement rules apply. So ask us before planning big work.
Aetna Dental DMO Plans
A DMO trades flexibility for lower, fixed costs. So here is how the Aetna Dental Direct DMO works.
β What is an Aetna DMO plan?
A dental plan where you choose a primary dentist and pay set copays.
Your primary care dentist coordinates your care. Then you pay fixed amounts listed on a fee schedule.
It works much like an HMO for your teeth. Also, compare it with PPOs on our dental insurance page.
β Does the Aetna DMO have waiting periods?
No. Coverage starts on day one for covered services.
That makes it a strong pick for urgent needs. Meanwhile, PPO plans wait six or twelve months for some care.
Fast access matters when a tooth already hurts. So call 888-730-6001 to check your ZIP code.
β Do I have to pick a primary dentist on the DMO?
β What does preventive care cost on the DMO?
Nothing. Exams, cleanings, X-rays and sealants cost $0.
Sealants apply to permanent molars only. Still, routine care costs you nothing.
Regular visits keep bigger bills away. Also, read our dental care guide.
β What do fillings and extractions cost on the DMO?
Fillings run about $26 to $63, and simple extractions about $8.
Surgical extractions cost about $65. Similarly, periodontal maintenance cleanings cost about $65.
Exact copays appear on your fee schedule. So ask us for the schedule in your area.
β What do crowns and root canals cost on the DMO?
Crowns run about $265 to $362, and root canals about $135 to $333.
Dentures range from about $174 to $483. Meanwhile, braces are not covered.
Fixed prices make budgeting simple. So compare them with PPO costs at 888-730-6001.
β Can I see a non-network dentist on the DMO?
β Is the Aetna DMO available in my area?
Only in some ZIP codes, since it depends on local network dentists.
The DMO may not reach rural areas. In that case, a PPO plan is the better choice.
We check your ZIP code during your quote. So call 888-730-6001.
β Should I choose a DMO or a PPO?
Choose a DMO for low fixed costs, or a PPO for flexibility.
DMOs skip waiting periods and use fixed copays. By contrast, PPOs let you see almost any dentist.
Your current dentist often decides it. Also, read HMO vs. PPO plans for the same idea.
β What is the alternate treatment rule?
If two treatments work, the plan may cover the lower-cost one.
You can still choose the pricier option. Then you pay the copay plus the difference.
Ask your dentist about options first. That way, nothing surprises you.
Aetna Vision Coverage
Clear vision should not cost a fortune. So here is how Aetna vision plans handle exams, frames and contacts.
β What Aetna vision plans can I buy?
Aetna Vision Preferred Direct in Value, Select and Elite tiers.
Each tier raises allowances and lowers copays. You can also add vision to a dental PPO plan.
There are no deductibles or waiting periods. So compare tiers on our vision insurance page.
β What does an Aetna eye exam cost?
$20 on Value, $15 on Select and $10 on Elite.
Dilation is included when needed. Meanwhile, the dental add-on vision plan covers exams at $0.
One exam is covered each benefit period. Also, read how vision benefits work.
β How much do Aetna vision plans pay for frames?
$130, $160 or $200, depending on your tier.
You also get 20% off the amount over your allowance. So pricier frames still cost less.
The add-on plan includes a $130 frame allowance. So ask us which fits your style.
β Do Aetna vision plans cover contacts?
Yes. Contact allowances match the frame allowance for your tier.
Medically necessary contacts get a $210 allowance. However, you choose glasses or contacts each period, not both.
Contact wearers often pick higher tiers. So compare with a free quote.
β What are the Aetna lens copays?
Standard lenses cost $25, $20 or $10 by tier.
Progressive lenses cost more, with tiered copays. Also, coatings like anti-glare add set charges.
Kids under 19 get polycarbonate lenses at $0 on Select and Elite. Also, ask us for the full list.
β How often can I use my Aetna vision benefits?
Once every 12 months for exams, lenses or contacts.
The benefit period runs 12 months in a row. Then your allowances reset.
Use benefits before they reset each period. Set a reminder after your first exam.
β Does Aetna vision help with LASIK?
Yes. Members get up to 15% off LASIK or PRK.
The discount comes through the U.S. Laser Network. Also, extra glasses cost up to 40% less.
Discounts are not insurance benefits and can change. So ask us what applies today.
β Can I see any eye doctor with Aetna vision?
Yes, but out-of-network visits pay you back less.
You pay at the visit and file a claim for reimbursement. In-network care costs less and adds discounts.
Search AetnaVision.com to stay in network. Also, read network cost differences.
β Should I add vision to my Aetna dental plan?
Often yes, if you wear glasses or want one simple bill.
The add-on includes a $0 exam and a $130 frame allowance. Meanwhile, stand-alone tiers offer bigger allowances.
Heavy eyewear users may prefer Elite. So compare bundles on our dental and vision page.
β What does Aetna vision not cover?
Medical eye treatment, vision therapy and nonprescription lenses.
Lost or broken glasses are excluded too. Likewise, two pairs in place of bifocals are not covered.
Your health plan covers medical eye problems. Also, read what health insurance covers.
Aetna Costs, Claims and Service
Price and paperwork questions deserve straight answers. So here is how Aetna costs, claims and service work.
β How much does Aetna dental insurance cost?
It depends on your state, ZIP code, age and plan level.
Core plans cost the least each month. Meanwhile, Preferred 2000 costs more but covers more.
Real quotes take minutes. So start a free quote now.
β Is Aetna dental insurance worth it?
Usually, if you get cleanings and expect some dental work.
Free cleanings and exams cover much of the premium. Then fillings and crowns cost far less.
Light users should compare a DMO or Core plan. Then we run the math with you.
β Do I need to file Aetna dental claims?
Not in network. Network dentists file claims for you.
Out-of-network dentists may ask you to file. In that case, send the claim with an itemized bill.
Keep copies of everything. Then read how claims work.
β How do out-of-network vision claims work?
Pay at the visit, then submit a claim for reimbursement.
Reimbursement maximums appear in your policy documents. Usually, they run below in-network allowances.
Save receipts and prescriptions. Also, we can help you file at 888-730-6001.
β What is an Explanation of Benefits?
A statement showing what the plan paid and what you owe.
It is not a bill, though it looks like one. Instead, compare it with the bill from your dentist.
Mistakes happen, so check each line. So read how billing works.
β What if Aetna denies a dental claim?
Ask why, then appeal with records from your dentist.
Common reasons include waiting periods, frequency limits and exclusions. Meanwhile, simple coding errors cause some denials.
Your dentist can resubmit with notes. Also, read how to appeal a denial.
β When will I get my Aetna ID card?
After enrollment, a welcome packet with your card arrives by mail.
Vision members also receive plan details and a provider list. Meanwhile, digital cards are available online.
Bring your card to every visit. Also, see how to read your card.
β What are the Aetna customer service numbers?
Dental enrollment help is 1-855-837-6453, and vision enrollment is 1-855-804-2410.
To find a dentist, call 1-877-238-6200. Also, TTY users can dial 711.
Member support is available seven days a week. Or call Vivna first at 888-730-6001.
β Can I cancel my Aetna dental plan?
Yes. Contact Aetna or your Vivna agent to cancel.
Cancelling ends your benefits on the stated date. Also, rejoining later may restart waiting periods.
Switching plans without a gap protects your coverage. Also, read how to switch plans.
β Does Vivna charge for help with Aetna?
Never. Licensed agent help is always free.
Carriers pay agents, so you never do. Furthermore, prices match whether you buy direct or through us.
Free expertise beats guessing alone. So learn more about Vivna Insurance.
π More Aetna, Dental and Vision Guides
These Aetna FAQs cover the essentials. So when you want more depth, these guides from our licensed agents explore dental care, vision benefits and plan networks further. Then, if a question remains, call 888-730-6001 anytime.
π More Aetna FAQ Guides
- When and How to Switch Health Insurance Plans
- Open Enrollment Period: Dates, Deadlines and How It Works
- Health Insurance for Kids: Options, Costs and Deadlines
- How to Read Your Health Insurance Card (Front and Back)
- Health Insurance Claim Status: What Pending, Processed and Denied Mean
- Benefits of Using an Insurance Broker: Cost, Choice and Help
𧩠Related Coverage & FAQs
π Questions About Aetna?
These Aetna FAQs answer the questions we hear most, but every family is different. Therefore, our licensed agents check your dentist and eye doctor and compare other carriers side by side, for free.
Best of all, our help costs you nothing. Request your free quote online, or call 888-730-6001 to speak with an agent today. You can also reach us through our contact page.
- π 888-730-6001
- βοΈ memberservices@vivna.net
- π Deerfield Beach, Florida
Official resources: the Aetna official website, HealthCare.gov, and the National Association of Insurance Commissioners.
Vivna Insurance is an independent, licensed agency offering Aetna individual dental and vision insurance products. Plans, benefits, and availability vary by state.