Picture this: you’re at the dentist, and your dentist slides a treatment plan across the chair. Crowns, bridges, implants, all with price tags that can make you gasp. Now add major service paperwork, coinsurance percentages, deductibles. It feels like a maze. If you have Aetna dental coverage, you’re in luck. Aetna’s plans often include restorative services that ease your path to a confident smile.
In this guide, you’ll learn:
- What restorative services Aetna covers
- How to get a pretreatment estimate to avoid surprise bills
- Key details on crowns, bridges, dentures, implants, root canals, and more
- Tips to make the most of Aetna benefits
Let’s get you from sticker shock to smiling again.
Aetna covered restorative dental services overview
Aetna offers dental plans that range from full-coverage PPOs (Preferred Provider Organizations) to discount-only options. With a full-coverage plan, you pay a deductible, then Aetna picks up a share of major services (typically 50% coinsurance). Basic services, like fillings and root canals, often cost you 20 to 30% after deductible. Preventive cleanings are usually free. Discount plans, on the other hand, let you pay reduced rates directly at the office with no claims. That can be handy if you need extensive restorative work right away.
Major services under Aetna typically include:
- Dental crowns and bridges
- Full and partial dentures
- Dental implants and related surgeries
- Onlays and inlays
- Bone grafts and sinus lifts
Most Aetna PPO, PDN (Participating Dental Network), and EPP (Exclusive Provider Plan) options do not require precertification for major services. However, Aetna recommends a pretreatment estimate for any work over $350 to confirm coverage details. If you want specifics on root canals and crowns, check out aetna root canal and crown coverage.
New enrollees may face a six- or 12-month waiting period for major services, so plan ahead. Your Summary of Benefits spells out those timelines.
Understand pretreatment estimates
Pretreatment estimates (also called predeterminations) give you a written breakdown of what Aetna will cover and what you owe. They take the guesswork out of billing surprises. Wondering how to get one?
- Ask your dentist for a treatment plan with procedure codes (CDT codes).
- Your dentist submits the plan to Aetna.
- Aetna reviews and sends back a cost estimate, usually in two to four weeks.
- You review the estimate, then schedule your care.
Remember, most estimates expire after 90 days. If you switch providers or modify treatment, ask for a new estimate. Having this estimate in hand keeps you in control of your dental budget.
Dental crowns and bridges
Fixing damaged or missing teeth with crowns and bridges restores both function and your confidence. Let’s unpack how these services work under Aetna.
Dental crowns
A crown caps a tooth to prevent cracks, hold a large filling in place, and improve appearance. Aetna covers all crown types under major services, meaning you pay coinsurance after reaching your deductible. Material choices impact cost, so chat with your dentist about:
- Porcelain fused to metal (PFM) crowns
- Full ceramic or zirconia crowns
- Full metal (often gold) crowns
Typical coinsurance for crowns is around 50% with full coverage plans, but discount plans may shave 20 to 30% off the office fee. If you’re curious about porcelain options, aetna covered porcelain crown replacement explains more. For gold crowns, see aetna insurance accepted for gold crowns.
Dental bridges
Bridges replace one or more missing teeth by anchoring false teeth to adjacent crowned teeth. Like crowns, bridges are major services under Aetna. Coinsurance kicks in after your deductible, and the number of units (teeth replaced) affects your portion. Here’s what to discuss:
- Span of the bridge (single tooth vs. multiunit)
- Type of pontic (false tooth material)
- Health of abutment teeth
If your bridge needs replacement, Aetna typically covers a new bridge after a minimum of five to seven years. For a look at BCBS coverage for similar services, visit bcbs covered dental crown and bridge.
Dentures and partial dentures
When you lose multiple teeth, dentures can bring back your bite and smile. Aetna covers dentures under major services with coinsurance after deductible.
Full and immediate dentures
Full dentures replace an entire upper or lower arch. Immediate dentures go in right after extractions so you’re never between smiles. Aetna’s discount dental plan removes the claim hassle—you simply pay the discounted rate at your dentist. To learn about fitting and follow up, check aetna covered denture fitting and follow up. Looking for Delta Dental details? See dentures covered by delta dental for seniors.
Partial and flexible dentures
Partial dentures fill gaps while keeping healthy teeth in place. Flexible partials use softer materials for a snugger fit. Aetna treats these as major services as well, with your share calculated just like full dentures. If you prefer a bendy base, compare options at cigna covered flexible partial dentures.
Implants and grafts
Dental implants can feel like the gold standard for restorative work, and Aetna does cover them under many plans. However, you’ll want to know how coverage breaks down for each component.
Standard implant coverage
An implant typically includes three parts:
- Implant post (titanium post in your jaw)
- Abutment (connector piece)
- Restoration (crown, bridge, or denture)
Aetna considers each item separately under major services. You’ll pay coinsurance after deductible, often around 50% per component. For details specific to retirees, check aetna dental implant coverage for retirees.
Bone grafts and sinus lifts
Not everyone has enough bone for an implant, so your dentist may recommend bone grafting or a sinus lift. Aetna categorizes these as major services too. Expect coinsurance after deductible, and ask about potential precertification for sinus lifts. For bone graft coverage specifics, see aetna covered bone graft for dental implants. While you’re at it, compare sinus lift coverage at uhc insurance approved sinus lift procedure.
Root canals and onlays
Root canal therapy
Root canals save infected or damaged teeth by removing infected pulp and sealing the tooth. Aetna typically lists root canal treatment under basic services. You might pay around 20 to 30% coinsurance after deductible. No prior approval is usually needed. For a complete breakdown, visit aetna root canal and crown coverage.
Onlays and inlays
When a filling isn’t enough but a crown is too much, inlays and onlays step in. Inlays fill inside the cusps of a tooth, while onlays cover one or more cusps. Aetna views these as major services, so you pay coinsurance after deductible, typically around 50%. For a look at BCBS policies, see bcbs covered dental inlays and onlays.
Maximize your Aetna benefits
Getting top value from your plan means working smarter, not harder. Here are smart moves:
- Stay in-network for negotiated rates and smoother claims
- Schedule major services early in your benefit year to use your full maximum
- Bundle treatments in one visit if possible to reduce multiple deductibles
- Keep up with preventive care—free cleanings can catch issues early
- Use HSA or FSA accounts to pay your share tax free
- Review your Summary of Benefits each year for plan changes
Not sure where to start? Call Aetna Member Services, or ask your dentist’s front desk to verify coverage before you pick up the phone.
Compare plans with competitors
It helps to see how Aetna stacks up with other big insurers. Here’s a quick look:
| Provider | Precertification for major services | Discount plan | More info |
|---|---|---|---|
| Aetna | No precert under PPO, PDN, EPP | Yes | — |
| Delta Dental | Varies by plan | No | full mouth reconstruction delta dental coverage |
| Cigna | No precert required for most | No | in-network restorative dental care with cigna |
| UnitedHealthcare | Generally no precert | No | restorative dental work with uhc coverage |
| BCBS | Plan dependent | Varies | restorative dentist accepting bcbs insurance |
While all major insurers cover restorative dentistry, each plan’s coinsurance rates, waiting periods, and network size differ. Compare your options before making a switch.
Key takeaways
- Aetna covers crowns, bridges, dentures, implants, onlays, inlays, bone grafts, and root canals, often at 50% or lower coinsurance after deductible
- Pretreatment estimates keep costs transparent, especially for services above $350
- Staying in-network, combining procedures, and tracking your annual maximum make a difference
- Compare your coverage with Delta Dental, Cigna, UHC, and BCBS to see who offers the best fit
Ready to take the next step? Talk with your dentist about a treatment plan, request a pretreatment estimate, and feel confident you know what your Aetna plan covers. Got questions or experiences to share? Drop them in the comments below.
