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Dental services

What's covered?

What's covered?

Aetna Assure Premier Plus (HMO D-SNP) covers all medically necessary dental treatment with a comprehensive dental benefit. Every member with an Aetna Assure Premier Plus (HMO D-SNP) plan gets access to this dental benefit, including members who qualify for:

 

  • Plans A, B, C, D or the Alternative Benefit Plan

  • Managed Long-Term Services and Supports (MLTSS) 

  • Fully Integrated Dual-Eligible Special Needs Plan (FI D-SNP)

Our members are covered for many general services, including:

 

  • Diagnostic services

  • Preventive services

  • Restorative services

  • Endodontic services

  • Periodontal services

  • Prosthetic services

  • Oral surgical services

  • Other adjunctive general services

Some procedures may require prior authorization with documentation of medical services. You can learn more about dental benefits in our Provider Manual (PDF).

LIBERTY Dental Plan providers

Aetna Assure Premier Plus (HMO D-SNP) uses LIBERTY Dental Plan to provide dental services for our members. LIBERTY Dental Plan covers routine and specialty dental services, the administration of the dental network, and claim payment for dental services.

 

To learn more, you can reach LIBERTY Dental Plan:

By phone

 

You can call them Monday through Friday from 8 AM to 8 PM at 1-855-225-1727.

Online

 

You can view the LIBERTY Dental Plan from their web portal.

 

View the LIBERTY Dental Plan

Members don’t need a referral to see a network dental provider. They can find a dentist using LIBERTY Dental Plan’s provider search tool.

 

Find a local dentist

New Jersey Smiles program

Through the NJ Smiles program, Primary Care Providers (PCPs) can apply fluoride varnish to children’s teeth as a preventive measure against cavities. They just need to receive appropriate training for this service.* They can also provide a cavity risk assessment and a dental referral for children 6 years or younger. 

 

*PCPs (pediatricians or physicians seeing pediatric enrollees), physician assistants and nurse practitioners can receive this training. 

All primary care dentists and PCPs should be up to date on prescribing fluoride supplements (based on access to and use of fluoridated public water). They’re also responsible for counseling parents and guardians of young children on oral health and age-appropriate oral habits and safety. And they should go over what dental emergencies are and how to use the emergency room for dental services. 

Fluoride varnish application will be combined with risk assessment and referral to a dentist who treats children under the age of 6. The services will be linked to well-child visits for children under the age of 6. They’ll also be reimbursed as an all-inclusive service billed using a current procedural terminology (CPT®) code and can be provided up to four times a year.  

 

The state periodicity schedule requires that a child be referred to a dentist for a dental visit before the child turns 12 months old. 

 

The carries-risk assessment service: 

 

  • is billed using a CPT code (the reimbursement will be the same regardless of the determined risk level),
  • must be provided at least once per year in conjunction with an oral evaluation service, and
  • must be provided by a primary care dentist.

 

It may be provided a second time with prior authorization and documentation of medical necessity. 

Have a question?

To learn more about our dental benefits, view the Provider Manual (PDF) or call Provider Experience at 1-844-362-0934 (TTY: 711). 

CPT® is a registered trademark of the American Medical Association.

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