Some dental practices have received notice that Aetna Medicare Advantage participation through Carrington will be eliminated beginning in September 2025. This change affects practices that currently rely on Carrington as their pathway for Aetna Medicare participation.
This page explains what this change means, what options practices have, and what considerations should be evaluated before choosing a path forward.
What Is Changing
Carrington will no longer provide in-network access to Aetna Medicare Advantage plans for affected practices. As a result, Aetna Medicare patients will no longer be considered in network through Carrington after the effective date.
This change does not affect Aetna PPO participation unless the practice makes additional contract changes.
Option 1: Remain Out of Network With Aetna Medicare
Practices may choose to remain out of network with Aetna Medicare after Carrington participation ends.
Key considerations:
Out-of-network benefits vary by plan
Some Aetna Medicare Advantage plans have no out-of-network benefits
Other plans may have reduced coverage
Practices should verify benefits carefully and prepare for possible patient impact.
Option 2: Seek Aetna Medicare Pickup Through Another Shared Network
Some shared network agreements may still pick up Aetna Medicare.
For example:
Connection Dental has been reported as continuing to pick up Aetna Medicare
Important cautions:
Many Aetna shared network agreements do not include Medicare
Each agreement must be verified individually
There is no guarantee of pickup
Option 3: Add a Direct Contract With Aetna
Adding a direct Aetna contract is the most reliable way to ensure continued Aetna Medicare participation.
Important points:
A direct Aetna contract picks up both Aetna PPO and Aetna Medicare
The direct contract fee schedule applies to both
Initial offers may be negotiable before acceptance
Practices should request a fee proposal and evaluate top procedure codes before making a decision.
Direct Aetna Contracts Override Shared Networks
A direct contract with Aetna will override:
Carrington
Other shared network agreements providing Aetna PPO
This applies to both PPO and Medicare plans.
Opting Out of Aetna Shared Network Agreements
When adding a direct Aetna contract, practices should also:
Review Aetna’s shared network agreements
Submit opt-outs where necessary to prevent other carriers from paying under Aetna fees
This step is especially important if the practice currently receives other carriers through higher-paying arrangements.
Summary
The removal of Aetna Medicare from Carrington requires practices to choose between remaining out of network, seeking another shared network path, or adding a direct Aetna contract. Practices should carefully evaluate benefits, reimbursement, and override implications before making a decision.
