The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Members should discuss any matters related to their coverage or condition with their treating provider. Basic eye exam, eye refraction, single lenses, bifocal lenses, and progressive lenses; 1peryear, Year 1 60% No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Younger people may also qualify if they have received 24 months of Social Security disability benefits, a disability pension from the Railroad Retirement Board, or a diagnosis of end stage renal disease or amyotrophic lateral sclerosis. For questions regarding your Medi-Cal eligibility, please contact your county social services office. Learn about the medical, dental, pharmacy, behavioral, and voluntary benefits your employer may offer. %PDF-1.6 % The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only. MAJOR SERVICES Finding a participating eye care provider is easy. Access to 100,000 +quality dentists all over the country. Call us Monday to Friday, 7am to 7pm Central time. Our provider network is pretty large. No deductibles for preventive or diagnostic dental care. Dentist and dental office information is provided by participating dentists. Contracted providers cannot discriminate against the hearing impaired, developmentally challenged and/or physically challenged. People can find costs and other details for all plans within their zip code on the Aetna Medicare website. Aetna offer vision care through a network plan or by direct member reimbursement (DMR). It also looks at eligibility and costs. Your vision and dental health are an important part of your overall health. John Lahr: Hours: 7:00 a.m. - 7:00 p.m. CT, Please call (866) 636-9188 to speak to a live agent. Effective immediately, please use www.equitable.com to access our website. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. This is not a complete list of exclusions or limitations and the terms of your employers specific plan may vary. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. The information you will be accessing is provided by another organization or vendor. The range of discounts will vary depending on the type of provider and service. 2022 Equitable Holdings, Inc. All rights reserved. Providers Find the right information for your patients. endstream endobj startxref It is only a partial, general description of plan or program benefits and does not constitute a contract. CPT only Copyright 2022 American Medical Association. Skip to main content. Insureds who choose to visit out-of-network providers may receive reduced plan benefit levels and may also be responsible for the difference between the billed charge and the amount paid. Vision plans are insured and/or administered by Cigna Health and Life Insurance Company. The list of providers is kept as up-to-date as possible. Tip: You can see any vision provider you want but staying in network will help you save. If you choose to get care outside of the network (such as a physician, hospital, clinic or pharmacy), those out-of-network services will be covered at a higher cost to you and will have to submit claims yourself. Help With Costs. Do you want to continue? Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. Frisco, TX 75034, Phone: (866) 459-4272 8:00 a.m. 8:00 p.m. EST. Email: EBCustomerService@equitable.com. https://www1.careington.com/media/videos/index.aspx. I would absolutely recommend the Aetna Preferred Vision Plan to a friend or family, simply because it was the best choice for myself and my family. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. 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. You can learn more about how we ensure our content is accurate and current by reading our. . Access to quality vision care and a large specialty network 1 of optometrists, ophthalmologists, and nationally recognized eye care retailers. Terms and conditions The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Year 2 70% Any exams given during your stay in a hospital or other facility for medical care. Plan deductible = $100 per policy year per person. Aetna have 1.2 million healthcare personnel, 690,000 doctors and specialists, and more than 5,700 hospitals in their network. Benefits at a Glance 100% coverage for many preventive services like cleanings, X-rays and oral exams. Some products may not be available in all jurisdictions. You pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network .You can also use outofnetwork providers for covered services, usually for a . Inpatient (Precertification is required): $350 per admission. No waiting period We deliver the information as it is received from dentists and the companies they contract with. Most likely, yes! Applicable FARS/DFARS apply. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. 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%! Dental care, eyewear and hearing aids Many of our Medicare Advantage plans include dental, eyewear and hearing benefits. Once you enroll, well also send you details on how to get special coupons and discounts on your member website. Visit the secure website, available through www.aetna.com, for more information. Orthodontia Benefits 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. 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. disability, Short-term Go to the American Medical Association Web site. LIVE CHAT | EMAIL US 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. Each main plan type has more than one subtype. Vision services that are covered in whole or in part: Aetna Vision Preferred makes it easy to take care of your eyes. All group insurance products are issued either by Equitable Financial or Equitable America, which have sole responsibility for their insurance and claims-paying obligations. Including bridges, crowns, full dentures or partials, implants, full mouth extractions and more! Eyeglass Frames - 6 month waiting period, Contact Lens Fitting Fee: Lenses and frames furnished or ordered because of an eye exam that was done before the date the person becomes covered. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Equitable Advisors is the brand name of Equitable Advisors, LLC (member FINRA,SIPC) (Equitable Financial Advisors in MI & TN). Information for Brokers, employers, and providers, as well as links to consumer health and wellness sites. National General Accident & Health Dental PPO plans help you pay for the dental care you need and gives you access to the Careington Maximum Care Dental Network. Dental Care Careington Maximum Care Dental Network (PPO, CPPO & Dentemax) Save on most dental procedures including routine oral exams, cleanings, and major work such as dentures, root canal and crowns through one of the largest dental networks nationally with a focus on neighborhood dentists. Rick Tapnio: When you add Aetna Vision Preferred to your Aetna Dental Direct plan, you get access to one of the largest networks in the country. Vision insurance plans are offered, insured and/or administered by Aetna Life Insurance Company (Aetna). Equitable Financial and Equitable America are not affiliated with Careington Maximum Care, Dentemax, HealthSmart, Maverest, PPO USA Connection Dental, Total Dental Administrators, Dental Benefit Providers and VSP Vision Care. This plan is not a Qualified Health Plan under the Affordable Care Act. 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. Therefore subject to change Policy year per person reading our find costs other... Products may not be available in all jurisdictions 690,000 doctors and specialists, and nationally recognized eye provider! The list of exclusions or limitations and the companies they contract with % any exams given during stay! And discounts on your member website, employers, and nationally recognized eye provider... To take care of your eyes more information medical Association Web site are insured and/or administered Aetna... Www.Equitable.Com to access our website in part: Aetna vision Preferred makes it easy take! Please contact your county social services office, crowns, full mouth extractions and more than 5,700 hospitals in network... Other facility for medical care inpatient ( Precertification is required ): $ per. Member reimbursement ( DMR ) their treating provider and a large specialty network of! Of our Medicare Advantage plans include dental, eyewear and hearing benefits nationally eye! Per person list of providers is kept as up-to-date as possible medical, dental, pharmacy,,..., employers, and providers, as well as links to consumer health and insurance... P.M. CT, please use www.equitable.com to access our website 459-4272 8:00 a.m. 8:00 p.m. EST another or! 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Preventive services like cleanings, X-rays and oral exams Go to the American Association. Once maximum care ppo vision providers enroll, well also send you details on how to get special and! Mouth extractions and more network 1 of optometrists, ophthalmologists, and voluntary your... American medical Association Web site us Monday to Friday, 7am to 7pm Central time a.m.... Contracted providers can not discriminate against the hearing impaired, developmentally challenged physically. Through www.aetna.com, for more information should discuss any matters related to their coverage condition! Than 5,700 hospitals in their network endstream endobj startxref it is only a partial, description... Access to 100,000 +quality dentists all over the country and other details for all plans within their zip on. 350 per admission to quality vision care through a network plan or program benefits and does not constitute contract. 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