Allina Health | Aetna is an affiliate of Allina Health and Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Allina Health | Aetna.
Learn about these benefits
You can find specific plan information in the Evidence of Coverage (EOC).
Network
Using an in-network provider for covered services generally costs less.
Dental benefits
Dental health is a big part of your total health and wellness. That's why our Medicare plans offer dental coverage.
Our dental plans offer both in-network and out-of-network dental coverage. When you see a provider in our dental network, you may save on covered dental services. Dental services you receive from an out-of-network provider are subject to any in-network benefit maximums, limitations and/or exclusions that may apply.
Out-of-network dentists are also not required to accept the plan’s payment as payment in full for covered services. Out-of-network claims are reimbursed up to the plan’s allowable amount for each covered service. That means your plan will pay its portion for covered services. If your out-of-network provider charges over the allowable amount for a covered service, you may receive a bill, and you’ll be responsible for payment of that bill.
See the dental schedule in your Evidence of Coverage (EOC) for more details.
Out-of-network providers are not required to bill us directly, but many will. If they won’t bill us directly, you pay for covered services at the time you get care. You’ll need to complete a reimbursement form and provide a detailed receipt with proof of payment. The form includes detailed instructions for submission and reimbursement. You can send us the reimbursement request either online or by mail.
To find an Aetna Dental® PPO network provider, use our search tool.
Vision benefit
Your vision is important to your health and wellness. We cover an annual eye exam and provide an annual benefit amount (allowance) for non-Medicare covered prescription eyewear. We have teamed up with EyeMed to provide this benefit.
You can use your benefit amount (allowance) to purchase covered eyewear at an EyeMed provider. Your benefit amount is applied at the time of purchase. If your eyewear purchase is more than your benefit amount, you’ll just need to pay the difference.
You may visit any licensed provider in the U.S. outside of the EyeMed network, but you may be responsible for additional costs. You may have to pay up front and submit a request to us to be reimbursed. Be sure to get an itemized list of the services received at the time of your visit.
To find an EyeMed network provider, go to AllinaHealthAetna.com/eyemed.
Hearing benefit
Your hearing is important to your health and wellness. Because of this, all of our plans include coverage for a hearing exam and hearing aids through a network provider. We have teamed up with NationsHearing® to provide your hearing exam and hearing aid benefit. Hearing aids must be purchased through NationsHearing to be covered.
We pay up to an annual allowance maximum per ear for hearing aids. You are responsible for any amount above the hearing aid coverage limit. Refer to your Evidence of Coverage (EOC) to learn more. Hearing devices with $0 out-of-pocket costs are available.
All hearing aid appointments must be scheduled through NationsHearing by calling 1-877-225-0137 ${tty}.
To file a claim
If you would like us to reimburse you for services or items, you will need to send us the information listed below. So be sure to ask for all the information you need while you’re there.
Ask for a copy of the receipt from the doctor/provider or the place you purchased your item from with:
- The date of service
- Your doctor’s/provider’s name
- Your doctor’s/provider’s address
- A short description of the services or items you want us to pay for. For example, tooth crown. Or the procedure codes, if any. Or prescription eyewear. Submit both the description and the codes if you have them.
- Your diagnosis codes from your doctor/provider
Also include:
- Your first and last name
- Your member ID number
- Your date of birth
Put your member ID on every item you send us. Including the receipt from the provider. Then, send them to us with your claim form.
More questions? Help is here
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