Aetna Dental Plans for Seniors

Aetna Dental Coverage Options

Aetna Dental plans are provided by Aetna Life Insurance Company, part of CVS Health.1 The carrier keeps it simple with three traditional dental PPO plans and a discount card option. You don’t need to select a primary caregiver and don’t need referrals to see specialists. To keep your out-of-pocket costs low, choose dental professionals from Aetna Dental’s network of providers.

Here’s a rundown of Aetna Dental’s top insurance plans for seniors. Once you choose the right plan for you, it’s easy to keep track of coverage details, payments and costs with Aetna’s handy online calculation tool on their member website.

Aetna Dental Direct Preferred PPO

This plan has the highest monthly premium cost by a few dollars, but it provides more comprehensive coverage than Aetna Dental’s other plans. So it’s a good choice if you anticipate you might need dental care beyond routine maintenance.

You can choose to see in-network dentists and specialists or out-of-network dentists. Out-of-network providers will cost more, whether you’re receiving preventive dental care or major dental work. This plan has an annual $50 deductible and the highest maximum benefit of all of Aetna Dental Direct plans, with an annual cap of $1,250. (The annual cap for out-of-network benefits is a little lower: $1,000.) Delta Dental plans typically have $50 annual deductibles. For comparison, UnitedHealthcare deductibles are usually $100. Some UnitedHealthcare DentalWise Max plans have much higher annual benefit caps, but premiums for those plans are higher, too.

Useful Resource: Everything You Need to Know About Insurance for Seniors

There’s no waiting period for preventive services such as X-rays and cleanings for any of Aetna Dental Direct plans. There’s also no waiting period for basic services, such as fillings or extractions, provided you had dental coverage for 90 days prior to enrolling. Keep in mind that if you didn’t have dental coverage previously, you’ll have to wait six months to have that work done and 12 months for major services, such as oral surgery or having dentures made.

For comparison’s sake: Cigna’s 3000/100 dental insurance plan has similar waiting periods to Aetna Dental Direct plans, for example, but some Humana dental plans have only 90-day waiting periods before you can use your insurance to help pay for basic dental services. UnitedHealthcare Dental Gen Plans for people over 64 years old, which are underwritten by the Golden Rule Insurance Company, have no waiting periods — even for major work like crowns and root canals.

Aetna Dental Direct Core PPO

Like the Preferred PPO plan, and Humana’s applicable dental plans, the annual deductible on the Direct Core PPO plan is $50 for individuals and $150 for families. The Core PPO plan costs several dollars less per month than the Preferred PPO plan and has a lower benefits cap at $1,000 ($750 for out-of-network providers). Cigna, by comparison, has plans with much higher annual benefit maximums.

This plan offers the same coverage for major work, such as oral surgery, crowns and dentures, as the Preferred PPO plan, meaning you would be responsible for half (50 percent) of the cost. An important difference between these two plans is in coverage for basic dental services. Patients with this plan will pay 30 percent more than the Preferred PPO plan for fillings, extractions and periodontal maintenance cleanings. For example, you pay half the cost of a filling or periodontal maintenance cleaning with the Core PPO plan but only 20 percent of the total cost with the Preferred PPO plan.

» Learn More: Dental Insurance Plans for Seniors

Gum recession, cavities and oral cancer are more common among older adults,2 so consider if you want a larger portion of basic dental care services covered with your plan. But if your dental health is generally good and you’d rather save a few dollars every month (which can add up to $60 or $70 annually, depending on your location and age), the Core PPO plan might fit your needs.

Aetna Dental Direct Preventive PPO

Seniors on a budget can choose this plan that provides preventive care only for roughly half the monthly cost of Aetna’s other PPO dental plans. Although basic procedures and major dental work are not covered, this plan provides exams, full-mouth X-rays and cleanings at no cost. Similar to Aetna’s other PPO plans, there’s no deductible to pay before you can receive preventive dental care.

This plan may be a good option if you don’t foresee major dental expenses in the near future or if you’re able to cover major dental expenditures that might come up. Those who’d prefer saving money now and taking their chances that they won’t need major dental work might be a good fit for this simple preventive care plan. Plus, the Preventive PPO plan makes you eligible for discounts at CVS stores with the ExtraCare Plus program. (Note that ExtraCare Plus is not currently available in Georgia, Louisiana, Minnesota, Missouri, New York, New Jersey, Oklahoma, Texas or Virginia.)

Aetna Vital Savings Dental Discount Card

Like Humana, Aetna offers a dental discount card, Vital Savings, that’s different from traditional dental insurance but can be a big help paying for dental care services. The card is pay-as-you-go, so you can cancel anytime.

Choose from a dental-only plan or a dental and prescription savings card. The dental-only card costs $8 per month for an individual and $11 per month for families. Note that there is also a $20 one-time startup fee. Dental Plus Rx (prescription) cards start at $10 per month for one person and $13 per month for a family.

You can use the card to help pay for crowns, cleanings, and even orthodontics and whitening at participating dentist offices. Aetna’s Vital Savings program has more than 260,000 providers, and your savings could be between 15 and 50 percent off dental services.

» FYI: Best Dental Plans for Seniors in 2024

Keep in mind that prices vary by area, and the Aetna Vital Savings program is unavailable in Montana, Vermont (dental) or Tennessee (prescriptions). It’s also a good idea to call to confirm whether a dentist listed in Aetna’s database as an in-network provider actually accepts the Vital Savings card. When we called to confirm that a dentist listed in Aetna’s database of in-network providers was in the network, we were told they do not accept the discount card, which had been the case for a long time.

Aetna’s Vital Savings Rx program has 68,000 participating pharmacies, and the card enables holders to save as much as 60 percent off of generic medications and 12 percent off of brand-name drugs.

Signing up is easy. You can get the card by signing up online, printing out a form and mailing it in, or calling to get the discount card over the phone.

Here are some examples of typical savings on dental care with the Vital Savings card. While these figures are from 2016, they can give you a good idea of the percentage savings you might receive:

We recommend calling Aetna to find out how much of a discount you can get on particular procedures or services you need. Calling Aetna Dental representatives is also advisable considering that the most recent cost estimates on the company’s website are from 2016.

Aetna Dental Plans for Seniors Costs

Costs for Aetna Dental plans vary depending on your age, geographic location and provider. To give you a ballpark idea of pricing, here are examples of coverage for a 60-year-old woman and 65-year-old man in Florida. Note that premiums are slightly higher for the older example, but coverage details are the same:

Aetna Medicare Advantage Plans With Dental Coverage

Dental care is typically not covered by Medicare, which can lead many seniors to skip needed dental procedures. Almost half of Medicare beneficiaries — and more than two-thirds of Black beneficiaries — did not visit a dentist in 2018. Lower-income seniors are also significantly less likely to visit a dentist than older adults in better financial circumstances.3

If you’re eligible for Medicare Part A and are signed up for Medicare Part B, you might be eligible for one of Aetna's Medicare Advantage plans with prescription drug and dental coverage.

» From the Pros: Guide to Medicare and Medicaid

Aetna noted in a 2023 press release that 87 percent of their Medicare Advantage plan subscribers are enrolled in plans rated four or more stars by the Centers for Medicare & Medicaid Services (CMS) annual Medicare Part C and Part D Performance Data report.4 These star ratings are based on the quality of health and drug services of Part D plans and customer experience. A 2023 J.D. Power survey of several Medicare Advantage market areas found that although there was not a huge difference in scores for overall customer satisfaction, Aetna ranked third among Medicare Advantage insurers in Florida, behind Humana and UnitedHealthcare.5

» More Ways to Save: 13 Things That Are Free for Seniors

Medicare pays a fixed amount to insurance companies offering Medicare Advantage plans, which is why premiums can be low or even $0 a month for eligible beneficiaries. You can search Aetna’s website for Medicare Advantage plans in your area by entering your ZIP code into the search box. You can also search for your primary care physician to see if he or she is in Aetna’s network and search for coverage information and pricing for your prescriptions.

Here are two examples of Aetna’s Medicare Advantage plan details available to seniors in Pinellas County, Florida:

Aetna Medicare Explorer Premier (PPO)

Plan details

• $0 premium (Note: You must continue to pay Medicare Part B premiums to be eligible.)
• $0 deductible
• Maximum out-of-pocket in-network spending: $4,700 ($9,550 for in- and out-of-network combined)
• You can use in-network or out-of-network providers, and you don’t need a referral to see a specialist. Note that if your current doctor or pharmacy isn’t in Aetna’s network, you’ll have to pick a new one.
• 24-hour helpline to speak to a registered nurse
• $30 in-network specialist
• Can see any licensed dentist in the U.S.
• $0 copay on dental exams, X-rays, cleanings, fluoride treatments and extractions
• $2,100 maximum benefit for preventive and comprehensive dental services combined

The Aetna Medicare Explorer Premier PPO plan also provides some coverage for vision care, mental health services, skilled nursing care and ambulance transport. Read the summary of benefits document for more information about other benefits, including drug coverage, medical equipment and fitness costs.

Aetna Medicare Assure Plus HMO

Plan details

• Premiums from $0 per month up to $37.70 (Note: Pricing example based on 2024 rates in Pinellas County, Florida. Aetna notes the Assure Plus HMO monthly premium is in addition to Medicare Part B premiums enrollees must pay.)
• Maximum out-of-pocket costs: $3,850
• Deductible: $0
• $0 doctor and specialist visits
• Must select a PCP (primary care provider)
• PCP approval needed to see specialists
• $0 lab services, diagnostic tests and X-rays
• Hearing services ($0 routine exams and hearing aid coverage up to $2,500 annually for each ear)
• Vision services ($0 routine and diagnostic eye exams and eyewear benefit amount up to $400 for prescription eyewear, including contact lenses, eyeglasses and frames)
• Dental care through Liberty Dental providers
• $0 for crowns, fillings and extractions
• 24-hour nurse line

The Aetna Medicare Assure Plus HMO plan also provides some coverage for mental health services, skilled nursing care, home health care, fitness services (free basic membership at SilverSneakers participating locations) and ambulance transport. Check summary of benefits document for more information about other benefits, including prescription drug coverage, medical equipment benefits and medical alert systems.

» Related Reading: Best Medical Alert Systems of 2024

How to Purchase an Aetna Dental Plan

You can sign up for Aetna Dental Direct anytime. Some insurance companies, such as Kaiser Permanente (with plans underwritten by Delta Dental), require you to wait until open enrollment periods to apply. (Kaiser dental plans are also only available as add-ons to existing health insurance.)

Purchasing an Aetna Dental Direct plan online is easy. On the website, you’ll be prompted to first enter your ZIP code and then some personal information, such as your birth date and status regarding dental coverage. You can choose to add a dependent to your plan or sign up as an individual. On the next page, Aetna will show you the plans available in your area with links to learn more about costs and benefits.

» Related Resource: Aetna Medicare Advantage plans

Once you choose a plan, you’ll add more information about your address and confirm your state residency and preferred language. After entering your information, Aetna will show you your monthly premium and start date for your dental coverage, and you’ll be prompted to enter your payment information. If you’d rather speak to a customer service representative, you can sign up on the phone.

Aetna Dental

Online reviews of Aetna Dental Direct are mixed. Some policyholders seem satisfied with their coverage and the number of in-network dentists available to them with Aetna Dental Direct. One reviewer, for example, appreciated that 80 percent of the cost of their crowns were covered.

Some reviewers wrote that Aetna’s website database of dental care providers is not updated, with incorrect addresses and dental care providers listed as in-network when they are not. Some reviewers cited a lack of quality dentists in their network and that Aetna would not cover the cost of dentures if a patient had previous extractions. Some reviewers said that claims for even routine cleanings were denied.

Final Thoughts

Many of Aetna’s dental plans have flexibility for policyholders to see specialists without referrals. We also like that their basic preventive dental care plan is less than $22 per month, which is a great option to keep basic dental hygiene costs low. Aetna also offers several free or low-cost Medicare Advantage plans with dental coverage and other benefits for seniors, including vision, hearing and fitness services, plus access to a 24-hour hotline to speak to a registered nurse.

Aetna Dental’s Vital Savings Dental Discount card is another great option that keeps dental care simple for older adults. With the Vital Savings card, you have access to discounted dental care on services that typically aren’t covered by insurance, such as whitening, for just $8 per month. Since you pay for these discounted services out of pocket with the Vital Savings card, there are no hassles with waiting periods, claims and waiting to get reimbursed.

Seniors looking for more comprehensive coverage might prefer the Aetna Dental Direct Preferred PPO, which we found cost around $42 a month for a 62-year-old woman in Florida. The Preferred PPO plan has some of the highest levels of coverage and annual deductibles of only $50. Although premiums for many plans are cheaper than other companies, Aetna’s annual benefits caps are on the low side. Overall, Aetna offers a variety of plans with great benefits that may be suitable for many older adults.