Aetna Dental, Vision and Hearing Flex

Every benefit below is transcribed from the Aetna Protection Series Dental, Vision and Hearing Flex and Dental Flex outlines of coverage CLIDF08350NV (Nevada edition), for policy form CLIDVHF24NV, and from the Aetna Dental, Vision and Hearing Flex consumer flyer CLIDF08409 (©2025 Aetna Inc.), which carries the overview of key coverage options, the Aetna Senior Supplemental Insurance company profile CGFMP08395, which states the A.M. Best rating and its date. Benefits, amounts and riders vary by state; the policy issued to you governs.

• Read this first: it is conditionally renewable, not guaranteed renewable Included

  You have the right to renew by paying the premium. The carrier keeps the right to stop renewing individual dental policies in the jurisdiction the policy was issued in, to stop renewing this policy form there, or to withdraw the plan design from all individual policies there. Any of those ends the policy.

  Every other dental policy published on our dental insurance comparison page is guaranteed renewable, and the Manhattan Life one is guaranteed renewable for life. This is a different promise, in the carrier’s own word, and it is worth understanding before you move a policy you already hold.

• Two policies on one form: with vision and hearing, or dental alone Included

  Dental, Vision and Hearing Flex covers preventive, basic and major dental services, orthodontia, and vision and hearing services. Dental Flex covers preventive, basic and major dental services only. Both are written on the same policy form and both may be offered with or without a preferred provider organisation for dental expenses.

  Here the vision and hearing coverage is part of one of the two policies rather than a rider you bolt on, which is a third shape again — different from the Manhattan Life policy’s riders and from the standalone vision plan on our vision page.

• It covers orthodontia, which most of the dental policies we compare do not Included

  Orthodontia is one of the four categories the Dental, Vision and Hearing Flex policy covers. What it pays is set by the schedule of benefits issued with the policy.

  None of the NCD plans on our dental insurance comparison page pay anything toward braces or aligners at any age. If orthodontia is why you are shopping, this is the one to ask about — and ask for the schedule, because this outline does not give the amount.

• What is not covered: the dental exclusions Not covered

  Impacted wisdom teeth. Occlusal, athletic and night guards. Treatment of disturbances of the temporomandibular joint, unless mandated by state law. Anything done because of abrasion, attrition, bruxism, erosion or abfraction. Preventive root canal therapy. Full mouth debridement. Surgical trays or sutures. Ridge preservation, augmentation, bone grafts and regeneration procedures in edentulous sites. Overdentures and precision attachments. Space maintainers and sealants for an insured over the age of 16. Duplicate or temporary appliances. Replacing a lost, stolen or missing appliance or prosthetic device. Oral hygiene instruction, plaque control and diet instruction. Orthodontic treatment begun before the insured person became covered under that section.

  Impacted wisdom teeth is the one that catches people, and it is not a usual exclusion — read it against the other policies on our dental insurance comparison page if that work is in front of you.

• And the missing tooth rule Not covered

  The initial placement of a prosthetic crown, appliance or fixed partial denture is not covered unless the placement is needed because of the extraction of one or more teeth while the insured person is covered under the contract — and the extraction of a wisdom tooth does not qualify. The appliance must include the replacement of the extracted tooth.

  Every dental policy on our dental insurance comparison page has a version of this clause. It is the single most common reason a bridge or denture claim is refused, and it turns on when the tooth came out, not on when you bought the policy.

• What the policy will not pay for at all Not covered

  Anything not listed as an eligible expense in the schedule of benefits, or not prescribed or performed by or under the direct supervision of a dentist, physician or provider. Anything not medically necessary, except teeth whitening services. Experimental or investigational procedures. Anything performed by a member of your immediate family. Charges in excess of the reasonable and customary charge. Treatment or diagnosis received outside the territorial limits of the United States. On-the-job or job-related illness or injury, or anything payable by workers’ compensation. Prescription drugs. Telephone consultations, missed appointments, X-ray copy fees and claim form completion. Ancillary charges including a hospital or ambulatory surgical centre, or use of provider office space. Local, state and federal taxes except where the law requires the carrier to pay them. Membership fees for a retail centre an affiliate or open access provider office sits in — and the outline says insured persons may be required to buy such a membership as a condition of getting benefits. Claims filed more than one year after the work was completed, unless it was not possible to submit proof of loss in time.

• Two limits on what the carrier will pay even when it does pay Included

  If you move from one dentist to another during a course of treatment, or more than one dentist performs services for a single eligible expense, the carrier is liable only for what would typically have been charged had one dentist done the work. And where you and the dentist choose a more expensive course of treatment than the profession customarily provides, payment is based on the charge allowed for the lesser procedure.

  That second one is the alternate benefit clause. It is why a claim on a crown can pay as though a filling had been done.

• You cannot hold two of these, and it will not coordinate with anyone else Included

  Dual coverage by you, or of a spouse or dependants, under another policy issued by the same carrier is prohibited. And if you have coverage under any other carrier, this one will not coordinate benefits with it.

  Worth knowing if you are holding a dental policy already and thinking of adding this alongside it.

• Three option levels, and the annual maximum is the first difference Included

  The annual maximum benefit is $1,000 to $5,000 on Option 1, $1,000 to $4,000 on Option 2 and $1,000 to $3,000 on Option 3, in $1,000 increments on all three. The deductible, per person per policy year, is $0, $50, $100 or $100 vanishing on Option 1; $0, $50 or $100 on Option 2; and $100 on Option 3.

  From the consumer flyer's overview of key coverage options. The flyer says in terms that it represents a partial list of services and that the outline of coverage and the policy govern.

• What each option pays, by type of work Included

  Preventive care is paid at 100% from day 1 on all three options. Basic care is paid from day 1 at 70% on Option 1, 60% on Option 2 and 50% on Option 3, rising after year 1 to 80%, 75% and 70%. Major care is paid from day 1 at 25% on Option 1, 20% on Option 2 and 10% on Option 3, rising after year 1 to 50%, 40% and 25%.

  Major work is paid from day one on all three options, at the first-year share. Read that against the NCD Value plan on our dental insurance comparison page, which pays nothing at all toward major work in its first year.

• Implants, on two of the three options Included

  The implant benefit is a $2,000 lifetime maximum on Option 1 and a $1,000 lifetime maximum on Option 2. The flyer shows implants as not applicable on Option 3.

  Which option you buy decides whether this policy covers implants at all, so it is worth naming the option before you compare premiums.

• Orthodontics, on two of the three options Included

  Orthodontics is paid after year 1 at 50%, with a $1,500 lifetime maximum on Option 1 and a $500 lifetime maximum on Option 2. The flyer shows orthodontics as not applicable on Option 3.

  None of the NCD plans on our dental insurance comparison page pay anything toward braces or aligners at any age, which makes this the one to ask about if orthodontia is why you are shopping.

• Vision, on two of the three options Included

  Vision is paid after 6 months at 70% on Option 1 and 50% on Option 2, rising after year 1 to 80% and 70%. The benefit is $250 per 2 years on Option 1 and $200 per 2 years on Option 2. The flyer shows vision as not applicable on Option 3.

• Hearing, on two of the three options Included

  Hearing is paid after year 1 at 80% on Option 1 and 70% on Option 2, to $500 per year on Option 1 and $250 per year on Option 2. The flyer shows hearing as not applicable on Option 3.

• Teeth whitening, on two of the three options Included

  Teeth whitening is $500 per year on Option 1 and $250 per year on Option 2, and not applicable on Option 3.

  It is the one thing the policy pays for that it does not require to be medically necessary — the exclusions list says so in terms.

• Credit for prior coverage, on Option 2 only Included

  The flyer's overview shows credit for prior coverage as No on Option 1, Yes on Option 2 and No on Option 3.

  The flyer does not say what the credit does. If you are replacing a dental policy you already hold, ask what it waives and get the answer in writing before you apply.

• How you are accepted, and how you are paid Included

  Acceptance is guaranteed with no health questions, at issue ages 18 to 89, for individuals, couples and families. Benefits are paid directly to you or to a designated provider, and you may use providers in or out of network. The policy carries a 30 day free look — return it for any reason within 30 days for a full refund of all premiums paid.

Issue ages

Issue ages 18 to 89. Written for individuals, couples and families.

Underwriting

Guaranteed acceptance — no health questions.

Renewability

Conditionally renewable. You have the right to renew the policy for consecutive terms by paying the required premium by the end of each grace period, subject to the policy termination provisions.

Financial strength

Rated “A” (Excellent) by A.M. Best as of 13 March 2024 — the third highest of sixteen ratings, which is the part the letter on its own does not tell you. It is a view of the insurer’s ability to pay claims, not a comment on this policy, and it can be changed at any time.

Policy form

CLIDVHF24NV. Form numbers and benefits vary by state.