When to Request a Pre-Treatment Estimate
A pre-treatment estimate is recommended whenever a course of dental treatment is likely to cost more than $300. Ask your dentist to write down a full description of the treatment you need, using either an Aetna claim form or an American Dental Association approved claim form. Then, before actually treating you, your dentist should send the form to Aetna.
Aetna may request supporting x-rays and other diagnostic records. Once all of the information has been gathered, Aetna will review the proposed treatment Plan and provide you and your dentist with a statement outlining the benefits payable by the Plan. You and your dentist can then decide how to proceed.
The pre-treatment estimate is voluntary. It is a service provides you with information that you and your dentist can consider when deciding on a course of treatment. It is not necessary for emergency treatment or routine care such as cleaning teeth or check-ups.
In determining the amount of benefits payable, Aetna will take into account alternate procedures, services, or courses of treatment for the dental condition in question in order to accomplish the anticipated result. See the Alternate Treatment (or Substitution) Rule here for more information regarding alternate treatment provisions of the Plan.
