Aetna PPO Dental Insurance Exclusions, Limitations, Frequencies, and Missing Tooth Clause
Aetna PPO Dental Insurance plans help you achieve and maintain good dental health which contributes to your overall health. Aetna PPO Dental insurance pays for a percentage of your dental treatment. Sunnyvale Dentist Dr. Antonious is a preferred provider for Aetna PPO Dental. He has agreed to accept the lower Aetna PPO Dental fees for patients who have purchased or had provided for them this type of coverage.
Contained In the fine print of insurance coverage booklets are limitations, exclusions, and sometimes a missing tooth clause. These terms can be difficult to understand but it is important to be educated on your individual insurance policy. The insurance professionals at Sunnyvale Dental Care will research and educate you on your insurance plan.
Frequency limitations are the number of times a patient is permitted to receive a particular covered service. For example, dental cleanings may be permitted every six months or two times during a calendar year. Limitations may also determine whether white composite fillings are covered at the same percentage everywhere in the mouth or just on anterior or front teeth. If coverage for bonded white composite fillings is limited to anterior teeth, patients wishing to receive them on posterior back teeth instead of silver amalgam fillings would have to pay a higher out of pocket cost for this type of restoration.
Some recommended services may be excluded by your Aetna PPO Dental plan when less expensive options are available. For some insurance plans, dental implants are one example. Some services such as sealants may be excluded after a patient exceeds a certain age. Sunnyvale Dentist Dr. Antonious will present to you all available treatment options and together you can choose a treatment plan that is best for you.
If your Aetna PPO Dental Plan contains a missing tooth clause, any tooth that was lost before insurance coverage began would not be covered. The denture, implant, or bridge needed to replace the tooth or teeth would have a 100% out of pocket cost to the patient.
The details of your individual Aetna PPO Dental plan can be accessed by the insurance professionals at Sunnyvale Dental care. They will pay careful attention to any exclusions, limitations, and missing tooth clause contained in your plan.