and Section 504 of the Rehabilitation Act of 1973. WebThe sequestration reduction amount for each affected claim will be identified on the explanation of remittance healthcare providers receive from Humana. Every enrolled family member may select their own primary care dentist. Aetna Inc. and itsaffiliated 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Ho0?4$#UVCr!bf! B[@U=7Y>6.vf Dental H|y\GozfKQgxDxk5Q"E[/P# GYf>WWU]z #Fv;t|*DDG&)07"jnlM&r3fLIsg@L?2t&&:r@p>_hwxwm!1IcNp,<6nfT^IAI. Treating providers are solely responsible for medical advice and treatment of members. 6p6@-_2PA p-S:{c:=q|%~nH09ML{Z 'zS'-'&w.&Xu-.@N 0000037168 00000 n Do you need a barcode cover sheet? In case of a conflict between your plan documents and this information, the plan documents will govern. WebLike most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions of benefits, limitations TmEg=boq1c8-,4%n (x@q U?eVzfK@X^=|?UOeq}:C |zYlK$"91q''o%$D?('N.. Links to various non-Aetna sites are provided for your convenience only. 0000086757 00000 n Links to various non-Aetna sites are provided for your convenience only. MetLife Preferred Dentist Program (PDP) Benefits 2022 You can find a network dentist with our online directory. 0000113149 00000 n Please see your plan documents. The $150 co-payment is for a plain metal crown. To find out, just call Member Services. Illinois DMO is not an HMO. You can also contact Member Services to determine if they are eligible under your DMO plan. HTn0?N$vt.taQ"]QI~}kGvc:PXJ ,DDIuEE}%uDp'QMXzm:h?cZH;%*E[*& CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies. Please see your plan documents. Select one of the SafeGuard DHMO Plans or one of the MetLife !f"UF =,T).ts Each DMO member must select a PCD. See Physician-related/professional services.). You may still elect to receive services from a non Find your dentist now in Aetnas large nationwide network. [Company Name] Plan Benefits 0000038186 00000 n Find the one that's right for you. (For example, a change made on April 16 will take effect June 1.). 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. Depending on your plan, you may pay for dental care in one of two ways: There are no deductibles or annual dollar maximums. endstream endobj 780 0 obj <>/Metadata 30 0 R/Pages 777 0 R/StructTreeRoot 55 0 R/Type/Catalog/ViewerPreferences 798 0 R>> endobj 781 0 obj <>/MediaBox[0 0 612 792]/Parent 777 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 782 0 obj <>stream The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. Yes. WebWe would like to show you a description here but the site wont allow us. hb``d``c``e`kgg@ ~'a >/*g3,>Ib1h(ettt4@ ceY Visit our Document submission cover sheets page to find the barcode cover sheets required with additional documentation. 0000037929 00000 n <<5AE96FDB43CC14498BFAFB7B8207E05A>]/Prev 310465/XRefStm 1499>> Florida endstream endobj 4799 0 obj <>stream 0000032811 00000 n Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. You may not have coverage to replace teeth that were lost or extracted before your coverage began. A dentist's reimbursement is a combination of: We have an arrangement with our DMO providers. As a MetLife Vision customer you can access language This search will use the five-tier subtype. m-4f'f{">H746Z5apg`u0? YN8e#'gxs4`T=>q{J&e-v%w+lC**hvD(5'-*GK v` For Apple Health clients and clients of the Developmental Disabilities Administration. It is only a partial, general description of plan or program benefits and does not constitute a contract. 0000001677 00000 n rxo @ e(m#GIByY6Cs|@5'C/9GL[sN`8!@d2j Spell out street names and abbreviations (State Highway 249 instead of SH 249). Log in to your member website first to get personalized results. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 0000001836 00000 n Each main plan type has more than one subtype. 0000000016 00000 n Fee Schedules endstream endobj 4805 0 obj <>stream startxref L0621014064[exp0622][All States]. The information you will be accessing is provided by another organization or vendor. You can see if your plan has a work-in-progress exclusion. Dental endstream endobj 4795 0 obj <>stream The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. endstream endobj 4806 0 obj <>stream 4+t?1zxn nmZn5&xUAX5N(;a,r}=YUUA?z r[ $ Dental Insurance Plans: Healthy Smiles Ahead | MetLife For questions about billing guides, contact Medical Assistance Customer Service Center (MACSC) online or at 1-800-562-3022. Some subtypes have five tiers of coverage. 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. BG[uA;{JFj_.zjqu)Q Aetna Inc. and itsaffiliated 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. If you do not intend to leave our site, close this message. This means if you have two plans that cover two cleanings per year, you dont have four cleanings per year. All Rights Reserved. Find individual dental insurance plans near you with budget-friendly coverage options and get a quote. Periodontal maintenance is for patients whove previously had periodontal treatment. WebMetLife has the largest range of dental insurance plans and providers among dental insurance organizations. WebJust select a participating dentist at enrollmentthen refer to your Schedule of Benefits to see what's covered and your costs. MetLife Find a dental plan thats right for you and your family, based on your needs and budget. 50% of costs until plan has paid $1,750, then any Register and log in to your member website. This Agreement will terminate upon notice if you violate its terms. xref hb```b`b`e`eb@ !f(GBC S1(500;1T5~`;4a> O@s'IW5yLrWqcrED]:b53l 2& CEg 120bpg7E'21Jn- (o-ee` y.4 H30-f1p' `[ 0000071744 00000 n endstream endobj 4796 0 obj <>stream Compare dental plans | Washington State Health Care Authority CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. All Rights Reserved. 0000039476 00000 n 0000021213 00000 n WebNot all employer groups associated with these Payors will utilize the Connection Dental Network. Any languages spoken in offices indicated in this search are self-reported. There are several types of coordination of benefits provisions. If so, we will confirm which plan has primary responsibility for claim payment. Verify the spelling of the provider's last name or office name. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. endstream endobj 4804 0 obj <>stream 163 44 While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Metropolitan Life Insurance Company, New York, NY 10166 Links to various non-Aetna sites are provided for your convenience only. %%EOF 163 0 obj <> endobj This material is for information only. endstream endobj startxref However, in order to receive maximum benefits, members must select and have care coordinated by a participating primary care dentist. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. H=o0w7S4oA2dhQ,QITEF}v@DN/8LBl^K]H*f:J]yDyS{dZ>L80|8xa@c7iCSY_yLdZ~2}e$LJV\+8CG09s^@wg8pn@\O9C3b\ O1^7TR6:'o9vS rp:QM{9l-k[[@szQV[*P/0chT}($^X'F-Bw)t]V[atF5]@R,hYxk,7Ge^AF*Ul. Bzb:5Gl8%bYYFMG`L"J/rrkBlF)ltPBVW oz WebWhen is periodontal maintenance covered? MetLife Dental Comparison Chart Dental WebDelta Dental has the largest network of dentists nationwide. Do you need a PA form? They may differ by plan. The AMA is a third party beneficiary to this Agreement. endstream endobj 4801 0 obj <>stream 4792 0 obj <> endobj Reprinted with permission. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Aetna Dental members dont need a member ID card to get dental care. hbbd```b`` 0000016556 00000 n endstream endobj startxref If we have primary responsibility, we will pay as the primary payor. endstream endobj 164 0 obj <>/Metadata 15 0 R/Pages 14 0 R/StructTreeRoot 17 0 R/Type/Catalog/ViewerPreferences<>>> endobj 165 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 -306.0 -396.0]>>/PageUIDList<0 152>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 166 0 obj [/Separation/PANTONE#20376#20C/DeviceCMYK<>] endobj 167 0 obj [/Separation/PANTONE#20347#20C/DeviceCMYK<>] endobj 168 0 obj [/Separation/PANTONE#202995#20C/DeviceCMYK<>] endobj 169 0 obj <> endobj 170 0 obj <>stream
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