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Learn about these benefits
You can find specific plan information in the Evidence of Coverage (EOC).
Network
Using a participating 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 plans offer dental coverage.
Our Choice PPO 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. You're responsible for any amount above the eyewear coverage limit. Refer to your Evidence of Coverage (EOC) to learn more.
When you use an EyeMed network provider, you don’t need to pay up front or submit a reimbursement form for covered prescription eyewear. It also includes an annual allowance to purchase prescription eyewear. Your plan covers one annual routine vision exam.
You may visit any licensed vision provider in the U.S. If you see a provider outside of the EyeMed network, however, 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: AllinaHealthAetnaMedicare.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. Our plan has 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 are available.
All hearing aid appointments must be scheduled through NationsHearing by calling 1-877-225-0137 ${tty}.
Submitting your reimbursement
Submitting your reimbursement
If your plan has a DMR structure, Allina Health | Aetna Medicare will need the information below to process your reimbursement request for dental or eyewear. You may need to obtain some of these items during your visit, so be sure to capture all needed information while you are there.
A copy of the paid itemized receipt from the provider, including:
- The date of service
- Your doctor's name (not the location or clinic name)
- The address of your provider
- A brief description of the service(s) or item(s) you are requesting reimbursement for (for example, D2740 porcelain crown)
- Diagnosis codes (for eyewear benefits)
Put your member ID number on every item you send us, such as the receipt from the provider. Fill out the online reimbursement form or you can mail these items to the medical claims address listed on the form.
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