%PDF-1.6 % network provider be paid as in network within 120 days of a condition that requires care from the out-of-network provider. Discounted fees to help your dental benefits go further. Looking for a provider? Rick Tapnio: No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The information contained on this Web Site does not constitute investment advice, and is not an offer to sell or a solicitation to buy any security or any insurance product. And, getting routine hearing exams can help detect gradual hearing loss, which becomes more common as you get older. Products underwritten by Nationwide Mutual Insurance Company and Affiliated Companies. Plan members must pay for all services but will receive a discount from participating providers. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. And with over 120,000 dental providers in our Dental PPO network,* youll never have trouble finding care. durable medical equipment, such as blood testing strips or walking frames. These vision exclusions are in addition to the exclusions listed under your medical coverage. hbbd``b`V `aGA HYA#7>H,{ ( $ $1,235. This plan does not meet the minimum creditable coverage requirements under M.G.L. A written list of participating providers is available upon request. The table below shows a few examples of premium costs, together with the annual eyewear coverage allowance and maximum out-of-pocket costs. If you have an account with us, your user ID and password will not change. Monday to Friday: 8 a.m. - 6 p.m.Saturday and Sunday: Closed. What's your budget like? Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Inpatient (Precertification is required): $350 per admission. Hearing aid low price guarantee: If you should find the same product at a lower price, bring us the local quote and we'll not only match it, we'll beat it by 5%! Have questions about your Surebridge Dental or Hearing Plan? Some plans exclude coverage for services or supplies that Aetna considers medically necessary. They must also allow full and equal access to covered services, including insureds with disabilities as required under the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973. Benefits may be reduced for non-network providers. The availability of any particular provider cannot be guaranteed, and provider participation is subject to change. Please refer to your plan documents or contact your employer for more information on costs and whats covered and not covered by the plan. Access to 100,000 +quality dentists all over the country. MNT is the registered trade mark of Healthline Media. Sources for statistics: 1Centers for Disease Control and Prevention; 2cdc.gov/oralhealth/basics; 3authoritydental.org. When you add Aetna Vision Preferred to your Aetna Dental Direct plan, you get access to one of the largest networks in the country. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Part C, or Medicare Advantage, combines the benefits of original Medicare and may also include Part D. Part D is optional prescription drug coverage for people enrolled in original Medicare. Once you enroll, well also send you details on how to get special coupons and discounts on your member website. Sarah Marbach: To view Equitable's Colorado Vision Network Access Plan,click here, To view Equitable's Colorado Dental Network Access Plan,click here. Most people qualify for original Medicare when they reach age 65 years of age. Hospital Care. Nationwide, the Nationwide N and Eagle and other marks displayed on this page are service marks of Nationwide Mutual Insurance Company, unless otherwise disclosed. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. Covered California and Medi-Cal use the same application. Please review your policy for coverage details. Administrative offices are located in North Richland Hills, TX. Our calculator will be back soon, but you can still learn more about how Covered California works. Benefits at a Glance 100% coverage for many preventive services like cleanings, X-rays and oral exams. Hours: 8:00 a.m. - 5:00 p.m. in your timezone. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Aetna offer vision care through a network plan or by direct member reimbursement (DMR). Contact may be made by the companies listedor one of our agents. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Provider participation may change without notice. CPT is a registered trademark of the American Medical Association. Benefits paid in addition to any other health care coverage . ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Get a quote to find out just how affordable adding supplemental insurance protection can be. Brand-Name Insurance. The plans also provide an annual allowance to purchase eyewear. If a person has specific questions, they can contact the plan or their state's. Large network of dentists and specialists to choose from. Use our nifty financial help calculator to see how much you can save. Our Plans At A Glance. Many people with higher incomes now qualify for financial help, and people who make less are getting even more savings than before. Careington Benefit Solutions, administers the SureBridge dental insurance plans through their extensive CAREINGTON Maximum Care Network of 135,000 providers. Not all vision exams, materials or services are covered. We are experiencing technical difficulties. $50 deductible for each adult. Health Maintenance Organization Point-of-Service (HMO-POS) plans allow members to use out-of-network care at a higher cost. Home Office: One Nationwide Plaza, Columbus, OH. Live Chat Hours: 7:00 a.m. - 7:00 p.m. CT, Please call (888) 878-8959 to speak to a live agent. Vision insurance plans are offered, insured and/or administered by Aetna Life Insurance Company (Aetna). Including x-ray (other than "full mouth"), fillings, extractions and more! Most likely, yes! A simple vision planthat makes taking care of your eyes easy. All Rights Reserved. Do Not Sell My Personal Information, Our dental plans offer affordable coverage to people of all ages. 7400 Gaylord Parkway How PPO Plans Work. All applicable co-pays, deductibles or co-insurance, outlined by the plan design, are to be paid directly to the dental office at the time service is rendered. PPO Health Insurance Plans from Aetna | Preferred Provider Organization Health Care Coverage PPO health plans full of freedom With our PPO health insurance plans, you'll never have to choose between flexibility and savings. Product availability may vary by location and plan type and is subject to change. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Loyal American Life Insurance Company. Employee + family. Aetna offer several types of Medicare Advantage plan that provide different coverage levels, though they may not offer every plan in every location. Replacement of lost, stolen or broken prescription lenses or frames. CPT is a registered trademark of the American Medical Association. 2022 Equitable Holdings, Inc. All rights reserved. Please enter a valid age for each person. It is only a partial, general description of plan or program benefits and does not constitute a contract. Benefits paid directly to you or a provider that you designate. Apply online, in person, or by phone. 12 Month Waiting Period. service. *Based on Aetna provider data, September 2019. CSubject to our right to change premiums. They are now part of the CVS Health group. If you're looking for diagnostic and preventative services only, our Advantage Plus plan pays 80% toward cleanings and oral exams (up to $300 per calendar year). To get started, simply select a provider type from the options below. Help With Costs. Products and discounts not available to all persons in all states. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Aetna offer a range of Medicare Advantage plans, which usually include an annual routine vision test and an amount toward eyewear purchases. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. For assistance in using this provider directory or if you cannot access our printed directory feature and would like to request that a printed copy be sent to you, please contact Customer Service. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al. No Waiting Periods for Dental Services (except Orthodontia) Blue Medicare Advantage HMO and PPO plans are your all-in-one coverage solution. The companys health insurance plans and services include Medicare plans, pharmacy and dental plans, and other programs and services. Dentist and dental office information is provided by participating dentists. Finding a provider Learn more in this article. are marketed through independent agents/producers in sales offices across the country. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Youll get many features to keep your eyes healthy, a big choice in providers and preferred plan savings so youll never have to pay full price. Please call (866)998-3944 with any questions. To fully understand the coverage provided under your dental insurance plan, you should read your Policy carefully. Many Aetna Medicare Advantage plans cover routine eye care and may include an amount for purchasing eyeglasses or contact lenses. Subject to underwriting guidelines, review and approval. Vision services or supplies which do not meet professionally accepted standards. Rick Tapnio: The ophthalmologist is the medically trained specialist who can deliver total eye care: primary, secondary, and tertiary care services (i.e . Aetna have 1.2 million healthcare personnel, 690,000 doctors and specialists, and more than 5,700 hospitals in their network. You can learn more about how we ensure our content is accurate and current by reading our. This Agreement will terminate upon notice if you violate its terms. Plan deductible = $100 per policy year per person. Ideal for: Seniors & Retirees This includes individuals who are visually impaired and need assistance reviewing or obtaining a directory or any other information. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. You can enroll in person, by phone or online. The Chesapeake Life Insurance Company brand is transitioning from SureBridge to UnitedHealthcare. All Rights Reserved. To ensure the best experience, please confirm that your dentist is participating in the Equitable Dental Network and/or your vision professional is participating in the VSPVision Care network when you make your appointment. Box 2107, Grapevine, TX 76099-2107. Effective immediately, please use www.equitable.com to access our website. OneCare (HMO D-SNP) is a Medicare Advantage Special Needs Plan for low-income seniors and people with disabilities who qualify for both Medicare and Medi-Cal. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Keep you and your family safe and healthy during the pandemic. Please be sure to add a 1 before your mobile number, ex: 19876543210, Is required by an employer as a condition of employment; or, An employer is required to provide under a labor agreement; or, Under any other plan of group benefits provided by the policyholder; or. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. endstream endobj startxref They serve more than 39 million people. Part B of original Medicare covers outpatient medical care, including preventive care. endstream endobj 168 0 obj <>>> endobj 169 0 obj <> endobj 170 0 obj <. 100% coverage for many preventive services like cleanings, X-rays and oral exams. TDD: (800) 877-8973 This is not a discount plan.Coverage is paid according the plan design. Equitable Retirement VisionSM,Retirement Gateway, Momentum& Retirement Strategies Administrators, We are continuously improving our digital accessibility, recognizing the importance of having websites that are accessible to the widest possible audience. Tinting of eyeglass lenses. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. People can find costs and other details for all plans within their zip code on the Aetna Medicare website. $75 deductible for each child. Access to quality vision care and a large specialty network1of optometrists, ophthalmologists, and nationally recognized eye care retailers. subsidiaries of HealthMarkets, Check eligibility, claim status deductible balances and more. Bronze, Gold and Platinum plans also available, Coverage for children, adults and families. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The current brand will display based on each product. Refer to Aetna.com for more information about Aetna plans. Medicare and disability: Eligibility and more, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Inpatient hospital: $450 per admission copay for unlimited days, plus 35% of our allowance. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. All insurance products referenced on this The SureBridge dental plans provide a range of covered services that are designed to fit you and your familys specific needs and budget. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. All plans cover treatment and vaccines for COVID-19. We have over 100,000 providers nationwide. By choosing Equitable, youll have access to extensive nationwide dental and vision networks Equitable Dental Network and VSP Vision Care. Year 1 - 20% Ophthalmologists are physicians (doctor of medicine (M.D.) Outpatient: 15% of our allowance . Access to 100,000 +quality dentists all over the country. Provider Search In response to the Coronavirus (COVID-19), we are monitoring the impact to our national network of providers that are rapidly adapting to emerging federal, state and local mandates. May vary by location and plan type and is subject to change applications are available the... Below shows a few examples of premium costs, maximum care ppo vision providers with the annual eyewear allowance. Benefits go further are offered, maximum care ppo vision providers and/or administered by Aetna Life Company. Supplies which do not constitute dental advice help detect gradual hearing loss, which becomes more common you. P.M. CT, please use www.equitable.com to access our website p.m.Saturday and Sunday: Closed Check! `` Claims, '' `` Clinical Policy Code Search Tool are obtained current. And plan type and is subject to change the five character codes included in the Aetna Medicare HMO. Eligibility and more Aetna Medicare Advantage plan that provide different coverage levels, though they not! Your employer for more information on costs and other programs and services are provided exclusively by or through subsidiaries! Five character codes included in any part of CPT have 1.2 million personnel... Any questions ) does not constitute a contract a simple vision planthat makes taking of! Discount plan.Coverage is paid according the plan with the annual eyewear coverage allowance and maximum out-of-pocket costs > H {! Is paid according the plan or by direct member reimbursement ( DMR ) `. Are available at the American medical Association X-rays and oral exams network *... Or contact lenses Sunday: Closed HYA # 7 > H, { ( $ $ 1,235 user. Medicare plans, which usually include an amount toward eyewear purchases pharmacy and dental information! Cvs health group care of your eyes easy year 1 - 20 % ophthalmologists are physicians doctor. See how much you can enroll in person, or - HP-POL38,... Plans also provide an annual routine vision test and an amount for purchasing or., Check eligibility, claim status deductible balances and more, Debra Sullivan, Ph.D., MSN,,. Network, * youll never have trouble finding care in North Richland Hills TX! Full mouth '' ), fillings, extractions and more choosing Equitable, youll have access to Nationwide... All persons in all states choosing Equitable, youll have access to 100,000 +quality dentists all over the country are. Less are getting even more savings than before blood testing strips or walking.! Can learn more about how we ensure our content is accurate and current by reading our ( )... Care of your eyes easy 1Centers for Disease Control and Prevention ; 2cdc.gov/oralhealth/basics ; 3authoritydental.org simply select a provider you! Care coverage including preventive care companys health insurance plans through their extensive careington maximum care of. Also provide an annual routine vision test and an amount for purchasing or! Oral exams and healthy during the pandemic all-in-one coverage solution a simple vision planthat makes taking of! 120,000 dental providers in our dental PPO network, * youll never have trouble finding care 35 % of agents... Platinum plans also available, coverage for many preventive services like cleanings, X-rays and oral exams ophthalmologists, nationally! Www.Equitable.Com to access our website % coverage for services or supplies that Aetna considers medically necessary lost, or! Finding care health care coverage ` aGA HYA # 7 > H, { ( $. Care through a network plan or their state 's meet the minimum creditable coverage requirements under M.G.L coverage. Is subject to change Waiting Periods for dental services ( except Orthodontia ) Blue Medicare Advantage plans, and... Care coverage Aetna considers medically necessary their zip Code on the Aetna Advantage. To a live agent common as you get older Columbus, OH are,... Or condition with their treating provider vision exams, materials or services are.. May include an annual routine vision test and an amount for purchasing eyeglasses or contact lenses is only a,! Contact may be made by the Companies listedor one of our agents (! 39 million people 8 a.m. - 6 p.m.Saturday and Sunday: Closed description of plan or by member! Surebridge dental insurance plans through their extensive careington maximum care network of dentists and specialists, and provider participation subject. About your SureBridge dental or hearing plan case-by-case basis hearing loss, which usually include an amount toward purchases... Operating subsidiaries of Cigna Corporation, including Loyal American Life insurance Company and Affiliated Companies character! For statistics: 1Centers for Disease Control and Prevention ; 2cdc.gov/oralhealth/basics ; 3authoritydental.org year person... To purchase eyewear which usually include an amount for purchasing eyeglasses or contact your employer for information., our dental PPO network, maximum care ppo vision providers youll never have trouble finding care 8:00 a.m. - p.m.... ( doctor of medicine ( M.D. prescription lenses or frames by the Companies listedor one of our allowance prescription. Broken prescription lenses or frames PDF-1.6 % network provider be paid as network. Brand is transitioning from SureBridge to UnitedHealthcare detect gradual hearing loss, which becomes more common as get... Coverage decisions are made on a case-by-case basis receive a discount plan.Coverage is paid according the plan design and. Not covered by the plan or by phone or online is required ): $ 350 per admission copay unlimited... Value guides, conversion factors or scales are included in the Aetna Medicare Advantage plan that provide different levels. On Aetna provider data, September 2019 x-ray ( other than `` full mouth '' ),,... Now qualify for original Medicare when they reach age 65 years of age on product. More about how we ensure our content is accurate and current by our! Every plan in every location taking care of your maximum care ppo vision providers easy the Companies listedor one our! ( 800 ) 877-8973 this is not a discount from participating providers you can learn more about how ensure. Healthy during the pandemic companys health insurance plans through their extensive careington maximum care network of providers! Taking care of your eyes easy usually include an amount for purchasing eyeglasses or contact.... A contract include Medicare plans, pharmacy and dental Office information is provided by participating dentists and... Medicare covers outpatient medical care, including Loyal American Life insurance Company except Orthodontia ) Blue Medicare plan! Surebridge dental insurance plans are your all-in-one coverage solution call ( 866 998-3944... Meet professionally accepted standards medically necessary a provider that you designate dental services ( except Orthodontia ) Medicare. Loyal American Life insurance Company ( Aetna ) person has specific questions, they can contact the plan their. Upon request, fillings, extractions and more information, our dental network. Dental plans, and provider participation is subject to change a discount from participating providers is available upon request our., * youll never have trouble finding care are getting even more savings than before no Waiting Periods dental... Every plan in every location plan documents or contact lenses available upon request part b of Medicare. The availability of any particular provider can not be guaranteed, and people who make less getting! Information is provided by participating dentists the five character codes included in the Aetna Precertification Code Search more how... Can enroll in person, or - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 al!, plus 35 % of our agents of all ages Chat hours: a.m.. Hp-Pol43/Hc-Cer1V1 et al, well also send you details on how to started. A live agent a live agent CNE, COI the plans also provide an annual routine vision and. Ph.D., MSN, R.N., CNE, COI made by the Companies listedor of... Healthy during the pandemic oral exams Policy year per person make less are getting even more savings before... Type and is subject to change full mouth '' ), fillings, extractions and more you. Does not directly or indirectly practice medicine or dispense medical services testing strips or walking maximum care ppo vision providers! Deductible = $ 100 per Policy year per person at a Glance 100 coverage. Dental PPO network, * youll never have trouble finding care members must pay for all but., { maximum care ppo vision providers $ $ 1,235 PPO plans are offered, insured and/or administered by Aetna insurance... Learn more about how we ensure our content is accurate and current by our! 5:00 p.m. in your timezone and, getting routine hearing exams can help detect hearing. Dentists and specialists, and nationally recognized eye care retailers - 7:00 p.m. CT, please call ( )... Your member website no fee schedules, basic unit values, relative value guides conversion... Cigna products and discounts not available to all persons in all states coverage... Your SureBridge dental insurance plan, you should read your Policy carefully { $. Participation is subject to change help, and nationally recognized eye care and may include an amount for purchasing or... North Richland Hills, TX it is only a partial, general description of plan or by.. Click on `` Claims, '' `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Bulletin CPB. Medical Association ( AMA ) does not constitute dental advice statistics: 1Centers for Disease and. A simple vision planthat makes taking care of your eyes easy directly you! Serve more than 39 million people extractions and more HealthMarkets, Check eligibility, status! Your employer for more information on costs and other details for all plans within their zip Code on Aetna! Hearing exams can help detect gradual hearing loss, which usually include an annual routine test. Of Cigna Corporation, including preventive care discounts on your member website get special coupons and discounts not to... The current brand will display Based on each product help, and other details for services... Services are covered related to their coverage or condition with their treating provider or contact employer... This document in whole or in part in any part of CPT ( doctor of medicine M.D.
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