Aetna Medicare Advantage Dental Coverage

In this article...
  • Most Aetna Medicare Advantage plans include dental coverage. Learn more about these plans, the dental benefits they may offer and how you may apply for an Aetna Medicare plan that covers dental benefits.

For many Medicare beneficiaries, one of the appealing features of most Aetna Medicare Advantage plans is the added benefit of dental coverage.

Because Original Medicare (Medicare Part A and Part B) does not include routine dental coverage and offers only limited dental services at all, millions of beneficiaries enroll in Medicare Advantage (Medicare Part C) plans like the ones available through Aetna to get extra coverage for things like dental, vision, prescription drugs and more.

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What Benefits Does Aetna Dental Offer?

Preventive dental care – which can include dental exams, X-rays, teeth cleanings and more – can be covered by many Aetna Medicare plans. Your Aetna Medicare Advantage plan may have an annual deductible along with copayments or coinsurance requirements for dental services, depending on the plan.

Many Aetna Medicare Advantage plans also include prescription drug coverage and may cover medications prescribed by your dentist following oral surgery or other procedures. 

Exact coverage may vary by plan, but some of the other covered dental services included in an Aetna Medicare Advantage plan can include:

  • Exams
  • X-rays
  • Cleanings
  • Fillings
  • Extractions
  • Root canals
  • Dentures, crowns, bridges and implants

Aetna Medicare and Medicaid

What Are Aetna Medicare Advantage Plans?

Medicare Advantage, otherwise known as Medicare Part C, is an alternative way to receive your Original Medicare coverage while also receiving some additional benefits not included in Medicare Part A or B.

Medicare Advantage plans are sold by private insurance companies like Aetna, and many plans include all of the same coverage as Original Medicare while also offering coverage for things like dental, vision, hearing, prescription medications and other things not covered by Original Medicare.

How does Aetna Dental Medicare Work?

Aetna Medicare Advantage plans can offer dental coverage in several ways, including through a dental provider network, direct member reimbursement for covered dental services or through optional supplemental dental benefits.

Network Coverage

Aetna Medicare Advantage plans may come in the form of HMO or PPO plans, among some other types of plan.

  • An HMO (Health Maintenance Organization) plan may include a network of dental providers that you can see for covered care. You may have a primary dentist who you will see for preventive care and other basic services, and your primary care dentist will coordinate additional care among the plan’s participating providers and issue referrals to see specialists. You are unlikely to receive any dental coverage if you stray outside of the plan’s network for care. 

  • A PPO (Preferred Provider Organization) plan also has a network of participating providers but may allow plan members to go outside of that network for covered care. PPO members may not need a referral from their primary care dentist in order to visit with dental specialists. If you visit a dentist outside of your Aetna plan network, you may be required to pay higher out-of-pocket costs than you would if you visit an in-network dentist.

Direct Member Reimbursement

Some Aetna Medicare plans give members a set amount of money each year (often called a plan allowance) to spend on dental care. You’ll typically pay for your dental care up front and then submit your receipt to Aetna and get reimbursed for covered care up to your plan allowance limit. 

These plans may not have dental network restrictions. If that’s the case, you can see any dentist who accepts Medicare, and your plan allowance can be used for covered dental services. 

Optional Supplemental Benefits

Not all Aetna Medicare plans include dental coverage. For those that do not, a supplemental dental package may be purchased and added to the plan. The dental package may also be added to plans that already include dental benefits for members who wish to enhance their coverage further. 

Aetna Medicare and Medicaid

How Much Does Aetna Medicare Dental Coverage Cost?

The cost of an Aetna Medicare Advantage plan with dental coverage varies, but many plans are available with $0 monthly premiums.

Depending on the plan, there may be deductibles, copays or coinsurance costs for some covered care. Preventive dental care is often fully covered by Medicare Advantage plans, with some restrictions.

How Do I Enroll in Aetna Medicare Dental Coverage?

In order to apply for a Medicare Advantage plan from Aetna or any other carrier, you must first be enrolled in Medicare Part A and Part B.

You may only enroll in a Medicare Advantage plan that is available where you live, and there are only certain times of the year in which you may enroll. A licensed Medicare insurance agent can help you review the Medicare plan options where you live, confirm your eligibility and walk you through the enrollment process if you’re eligible to apply.

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