Aetna Dentist in Pasadena, CA: We Accept Aetna PPO Plans

Reading Your Aetna Card: PPO, Direct Plan or Access Card

Reading your Aetna card tells you whether you hold a PPO plan, a direct plan or an access card. The plan name appears on the front of the card, usually near the Aetna logo. Many employers offer Aetna dental coverage alongside health insurance, and your dental insurance policy lists the plan name. A PPO plan lets you choose your dentist, and this office accepts Aetna PPO plans. A direct plan carries its own tier name. An access card works as a discount program instead of insurance.

The table below shows how the three card types differ for claims and yearly limits.

Aetna Dental Direct PPO Plans

Aetna Dental Direct PPO plans appear at this office as three tiers: Preventive, Core and Preferred. Each tier pays a different share of basic and major care, and a percentage of each bill. Ask whether your plan covers your family. Check the tier name on your card. The tier decides how much of a filling or crown your plan pays. The front desk can read the tier with you when you call.

Aetna Dental Access Is a Discount Program, Not Insurance

Aetna Dental Access is a discount program, not insurance. It lowers the fee you pay directly for covered services. It has no claim forms and no annual maximum. Call the office with your card details, and the team will explain how the discount applies to your visit.

What an Aetna PPO Usually Pays Toward Preventive, Basic and Major Care

An Aetna PPO usually pays toward preventive, basic and major care in three different shares. Most Aetna plans follow this tiered pattern. Preventive care often receives the largest share, and basic care receives a smaller share after your deductible. Major care receives the smallest share. Your plan sets the exact percentages, the deductible and the annual maximum. The office confirms those figures before treatment starts.

The table below matches each care tier to the services this office provides.

Preventive: Exams, Cleanings and X-Rays

Exams, routine cleanings and X-rays make up preventive care on most PPO plans. They support preventive healthcare and oral hygiene. Many plans pay these visits at or near the full amount. Your plan decides how many cleanings it pays each year. Some plans apply waiting periods to other care, so ask before you schedule anything beyond a checkup.

Basic: Fillings, Extractions and Gum Care

Basic care covers fillings, extractions and gum care. This office places tooth-colored fillings that repair decayed teeth, performs simple extractions and treats periodontal disease with deep cleaning. Many plans pay a smaller share here than for preventive care. You usually meet your deductible first.

Major: Crowns, Bridges, Dentures and Root Canals

Major care covers crowns, bridges, dentures and root canals, the restorative procedures that rebuild damaged teeth. This office makes porcelain crowns and bridges, fits complete and partial dentures and performs root canal therapy. Major care often receives the lowest share of the three tiers. Dental implants may need prior approval from Aetna, and coverage for them varies widely.

Questions worth asking Aetna about major care:

• What deductible applies to crowns, bridges and root canals?
• How much of my annual maximum remains this plan year?
• Does my plan apply a waiting period to major care?
• Does my plan require prior approval for this treatment?

In-Network or Out-of-Network: How Your Aetna Bill Changes

In-network or out-of-network status changes how your Aetna bill is calculated. An in-network dentist agrees to Aetna's contracted rates, so the plan applies its negotiated fees. An out-of-network dentist may charge a standard fee, and the plan may pay a smaller share of it. Your share of the bill can differ between the two.

Pasadena Dental Office and Orthodontics accepts Aetna PPO plans. The team can confirm how your specific plan treats this office before you book. Ask for that confirmation first, because network status shapes every estimate you receive.

Verify Your Aetna Coverage Before You Sit in the Chair

You verify your Aetna coverage before you sit in the chair by checking with Aetna and the office. Your card lists a member services number that answers dental questions. The office then reviews your coverage and will provide an estimate before treatment begins. The team checks your policy on your behalf. Two short calls settle most questions.

Follow these steps before your first visit:

1. Find the member services number on the back of your Aetna card.
2. Log into the Aetna member portal to see your remaining annual maximum and deductible status.
3. Call (626) 219-7180 with your member ID and group number.
4. Let the team review your plan and estimate your share of the planned treatment.
5. Bring your card to your appointment.

As reported by CMS, patients paid 38.3 percent of dental spending out of pocket in 2024. Health care overall left patients paying 10.5 percent out of pocket.^[1] That gap is why a benefits check pays off before you start treatment. Your plan documents and this office together give you a clear number to plan around.

Aetna Benefits Do Not Roll Over: Time Your Care to Your Plan Year

Aetna benefits do not roll over, so you should time your care to your plan year. Many dental plans reset on a fixed date. Check your plan documents for your reset date. Any unused benefits expire when the plan year ends. Schedule your exams and needed treatment before that date to use the benefits you already paid for.

As reported by the ADA Health Policy Institute, 58.2 percent of privately insured people visited a dentist in 2023. Only 28.4 percent of uninsured people visited a dentist.^[2] Insured patients who use their benefits tend to see a dentist more often. The team can also discuss whether splitting a large treatment plan across two plan years fits your situation.

No Aetna Plan or a Gap in Coverage? Payment Options at Our Office

Payment options at our office help patients who have no Aetna plan or a gap in coverage. The office works with financing partners that spread a treatment plan into monthly payments and make it more affordable. The office offers flexible payment options and payment plans through these partners. Ask the front desk about them at any visit. The team explains the options before you commit to treatment.

The office works with financing partners such as:

• CareCredit
• Cherry
• LendingClub
• Sunbit

As noted by the ADA Health Policy Institute, 12.7 percent of Americans skipped needed dental care because of cost. Medical care showed a rate of 5.2 percent.^[3] A gap in coverage is a common reason people delay care. The table below shows what to ask for in three common situations.

Your Aetna Dentist: Dr. Solomon Heifets, DDS

Dr. Solomon Heifets, DDS, is your Aetna dentist at Pasadena Dental Office and Orthodontics. He leads the practice as its main dentist. He belongs to the American Dental Association and the California Dental Association. Our team speaks English and Spanish, and hygienist Bianca holds a laser dentistry certification.

The office has a wheelchair accessible entrance and offers free street parking and a free parking lot. Patients can also reach the team by phone at (626) 219-7180 during office hours.

Using a Different Carrier? See the Plans We Accept

You can see the plans we accept if you use a different carrier. The office accepts most major PPO dental plans in addition to Aetna. The list below shows examples. Call the front desk if you do not see your carrier.

Carriers the office accepts include:

• Delta Dental
• MetLife
• Guardian
• Cigna
• Anthem Blue Cross
• Blue Shield
• United Healthcare
• Humana
• Ameritas
• United Concordia
• Principal Financial Group

Ready to Use Your Aetna Plan? Call (626) 219-7180 or Book Online

You can use your Aetna plan by calling (626) 219-7180 or booking online. Have your member ID and group number ready when you call. The front desk is open Monday through Friday from 9 AM to 6 PM. The office sits at 181 N Hill Avenue in Pasadena.

Pasadena Dental Office and Orthodontics accepts Aetna PPO plans and checks your benefits before treatment begins. The front desk explains what your plan covers and what remains for you to pay. Call (626) 219-7180 or request an appointment online to start with a benefits check. Patients with other carriers receive the same benefits check, and patients without a plan receive a clear payment discussion. The team answers every question about your plan year. Bring your Aetna card and your member ID to your first visit.