2016 DMO Dental Provider Directory - Aetna

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AETNA MEDICARE

2016 DMO Dental Provider Directory



NEW YORK

This directory was updated on 7/1/2015. For more recent information or other questions,

please contact us at 1-800-282-5366 or for TTY users, 711,

8 a.m. to 8 p.m., seven days a week,

or visit .

1-800-282-5366TTY711

Y0001_1080_5306_FINAL_24 Accepted 7/2015

18.01.317-CH (7/15) NEW YORK

Table of Contents

Aetna Medicare dental plans ..................................................................................................................................................II

Section 1 - Introduction ..........................................................................................................................................................III

Chinese version...........................................................................................................................................................................V

Primary care dentists .................................................................................................................................................................2

Specialty dentists .....................................................................................................................................................................54

Index of providers speaking additional languages ........................................................................................................90

Index..........................................................................................................................................................................................110

Disclaimers.....................................................................................................................................................Inside back cover

I

Aetna Medicare DMO

Dental Provider Directory

This directory provides a list of Aetna Medicare network dental providers. This directory is for New York. This directory includes the Chinese translated version. A Chinese version of the Introduction follows the English version. Chinese translation can also be found throughout the directory and on the tabs of each section. This directory is current as of 7/1/2015. Some dental providers may have been added or removed from our network after this directory was printed. We do not guarantee that each dental provider is still accepting new members. To get the most up-to-date information about network dental providers in your area, you can call our Member Services department at 1-800-282-5366 (TTY: 711), 8 a.m. to 8 p.m., seven days a week. Or visit . This information is available for free in other languages. Please call our Member Services number at 1-800-282-5366 (TTY: 711). Hours of operation: 8 a.m. to 8 p.m., seven days a week. 1-800-282-5366 TTY 711 Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

II

Introduction This directory provides a list of Aetna Medicare DMO dental providers. To get detailed information about your dental coverage, please see your Evidence of Coverage. The "network providers" listed in this directory have agreed to provide you with your dental services. You may go to any of our network dental providers listed in this directory; however, some services may require a referral. If you have been going to one network dental provider, you are not required to continue to go to that same dental provider. In some cases, you may get covered services from out-of network dental providers. In cases where non-contracting dental providers submit a bill directly to you, you should not pay the bill, but should submit it to Aetna Medicare for processing and determination of your cost-sharing amount, if any. Certain network health care services require prior authorization from Aetna Medicare. This means that the service must be approved by Aetna Medicare before it will be covered under the plan. Check your Evidence of Coverage for a list of services that require this approval. When you are to obtain services requiring prior authorization from a network dental provider, the dental provider is responsible to obtain prior authorization from Aetna Medicare before treatment. If your plan includes an out-of network benefit and you decide to receive covered services from an out-of-network dental provider, we recommend you ask your out-of-network dental provider to contact Aetna Medicare for prior authorization of those services. If you're enrolled in an Aetna Medicare DMO dental plan:

? You must choose a primary care dentist (PCD). This directory lists our network dentists. ? Generally, you must get dental services from your PCD. ? Your PCD may refer you to participating specialty dentists for certain services. ? For some services, your PCD has to get prior authorization before treating you. ? You must use network dentists, except for an emergency. (See emergency services section for

more details.)

III

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