Frequently Asked Questions |
Dental Questions
Vision Questions
Q: How long has Aetna been in business? |
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A:
Aetna has been providing a highly credentialed and quality network nationwide for over 40 years.
It is one of the largest healthcare companies in the world.
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Q: What is the DentAchoice Card? |
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A:
The DentAchoice Card is a wholly owned subsidiary of
National Benefit Builders Inc. It currently markets two networks to the public,
Aetna Dental AccessSM and the ECI Vision networks.
Both these networks are among the most respected in America.
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Q: Who is included under a household plan? |
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| A: All members of the household are included regardless of age. |
Q: Is this an insurance plan? |
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| A: No. The DentAchoice card is a reduced-fee-for-service program. It is not insurance. |
Q: Can I nominate my dentists if they are not in the network? |
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| A: Yes. If your dentist is not in any of our networks, we will make every effort to solicit his/her membership. |
Q: What if I want to change my dentist? |
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| A:
Members may change dentists at any time without notice to Aetna Dental AccessSM. You should check our web site or call our customer service center to make sure that the dentist you have chosen is still in the network. |
Q: Can I just use the plan for orthodontia services? |
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| A: Yes. The savings realized on orthodontia services are the reasons many members purchase the DentAchoice card. |
Q: Are there any limits on the type of services included? |
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| A: No. There are no limits whatsoever, except work in progress. You can go to the dentist as often as you like and get whatever services you need at discounted prices. |
Q: How do I find out what the cost of a dental procedure will be? |
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| A: Plan members are given a comprehensive list of procedures when they join. You may also call our toll-free Member Services number to find out what the reduced fee is for any dental procedure or service. |
Q: Why do dentists join the plan? |
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| A: The dentists who join the plan are interested in the opportunity to grow their patient base. They want to develop long-term relationships with their patients and are committed to offering affordable dental care. |
Q: How long before my dental plan is activated? |
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| A: You can start using your dental plan as soon as you receive your ID card(s) and fulfillment package. You should receive your fulfillment package and ID card(s) within 5 to 10 days. |
Q: How much of a discount can I
expect? |
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A: You will save from 20% to 70% on eye care and from 40% to 60% on eyewear. We have a consistent national pricing structure.
For surgical eye care procedures, our ophthalmologists discount their fees 20% below the Medicare allowable rate. For example, if cataract surgery were to cost $2,500 and Medicare would allow $1,000, you would pay only $800, a savings of 68%. You can also save on traditionally non-covered procedures such as vision correction surgery (RK, Excimer Laser and LASIK) and cosmetic surgery (CO2 Laser skin resurfacing and eyelid surgery).
For eye wear, our optometric providers utilize the "Frames" wholesale pricing structure for our members purchasing glasses, plus a modest dispensing fee, which ranges from $30 to $50, depending upon the complexity of the lenses. The savings usually range between 40% and 60%, but never less than 20%. Our providers also dispense contact lenses (except disposables which are available through mail-
order) at a savings of 20% and sunglasses at prices 20% below retail. This is in addition to the mail-order part of the program where much greater savings are available.
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Q: What about the contact lenses? How much can I save through the plan? |
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| A: If you purchase contact lenses at a provider location, the discount is 20% (disposable contacts are not discounted). However, you may save considerably more by using our special mail-order program to purchase replacement contact lenses at wholesale pricing (including disposables). The mail-order savings generally will be around 50%. |
Q: How can the ECI Vision Plan provide these benefits? |
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| A: The ECI Vision Plan Provider Network has a very large membership base and therefore has been able to negotiate substantial discount contracts with vision providers. When joining our plan, a vision provider's patient volume generally increases so he/she can more than make up for the reduced pricing. |
Q: How often can I use the ECI Vision Plan? |
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| A: There is no limit to how many times you can use the program or how much money you can save. As long as you are a paid member, you may use the plan as often as you like. |
Q: I have a pre-existing condition which needs treatment. Can I still use this plan? |
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| A: Yes. There are no restrictions with the plan. Once you receive your membership card, you can visit any of the network providers and start saving right away. |
Q: If I have vision insurance, do I need this plan also? |
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| A: This plan works very well with vision insurance. Here's why. Your out-of-pocket costs may be lower because the percentage of the bill you must pay will now be based on a total lower bill. For example, if you have a $300 bill for eye glasses and your insurance pays 60%, then you must pay 40% or $120. Now let's assume that as an ECI Vision Plan member your bill is discounted to $150. You now must pay 40% of $150 or $60. You end up saving $60 (the difference between $120 and $60). |
Q: What qualifications must a vision provider meet to join your network? |
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| A: Each one of our ophthalmologists and optometrists undergoes a thorough credentialing process and must pass strict guidelines in order to join our network. The process includes verifying professional credentials, licenses and liability coverage. Only qualified professionals are accepted for participation. |
Q: My personal optometrist/ophthalmologist is not currently participating in your
network. What does he/she have to do to participate? |
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A: He/She must call 1-800-354-8336 and request the necessary information to apply.
VERY IMPORTANT: Do not call for your provider. We must talk personally with him/her to verify information needed to apply.
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Q: Can I change providers? |
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| A: You may change providers any time you wish. All you would need to do is select another provider from the list of participating providers (click PARTICIPATING PROVIDERS to locate participating providers in your area). It's that easy. |
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