Check Benefits & Eligibility

Verify benefits eligibility information electronically

Electronic eligibility and benefits information is available at any time, for all our dental plans.

Where can I go to look up benefits and eligibility?

You can check benefits and eligibility by:

• Using Aetna Voice Advantage® (AVA), our interactive telephone self-service system
• Registering with or logging in to your secure site
• Using an electronic transactions vendor

See benefits and eligibility instructions for AVA

Log in or register
See a list of electronic transactions vendor

What do I need to submit an inquiry?

The information you’ll need depends on the method you use to submit an inquiry.

If you’re using AVA, you’ll need:

• Provider TIN or NPI
• Patient ID or subscriber’s Social Security number
• Patient date of birth
• ADA code (if using Benefit Details)
• Fax number

If you’re submitting online, you’ll need:

• Provider TIN and NPI
• Patient ID or subscriber’s Social Security number
• Patient date of birth
• NOTE: some vendors may require more information to process your request.

What information can I get?

Information you can get includes:

• Payer information – name and ID
• Requesting provider name and number with associated information
• Subscriber/patient information:

SSN or member ID
Group name/number and/or plan name/plan number
Insurer name, address
Date of birth
Gender
Facility name and address (claim office)
Plan begin date

• Procedure code
• Active coverage
• Coverage level
• Insurance type
• Detailed financials, as applicable (copay, deductible, frequencies etc.)

Depending on the method you use to submit an inquiry, you may not receive all of this information.

What if I get an error response?

Your message will explain the cause of the error. Depending on the error, you may have to re-enter your data or contact your vendor for help.