Dental, Vision and Voluntary plans

Aetna will allow your dentist to determine what constitutes an emergency and Aetna will cover emergency care for both PPO and DMO members with no referral required.

You should call your dentist’s office to find out how they are handling emergencies and follow their instructions. If you are having trouble reaching your dentist directly, you can contact Aetna member services and our team will assist you with finding a dental provider.

Aetna will pay all out-of-network emergency claims as in-network during this time for both DMO and PPO members.

Aetna will grant an extension once dental offices reopen. More details will be communicated in the coming weeks.

During this time many dentists are offering tele-dentistry services to facilitate emergency oral evaluations of their patients using telephone and video-conferencing capabilities. We encourage members to contact their current dentist to see if such services are offered.

If they are being offered, Aetna’s policy has always been that any oral evaluation covered under our dental plans will be reimbursed no matter whether it is performed via tele-dentistry or in a traditional practice setting. Aetna will cover all emergency exams at 100% during the COVID-19 pandemic crisis.

Yes. Aetna has launched a new tele-dentistry program to provide dental members with a simple, convenient solution to access care from the convenience of their homes.

How it works:

• If a member has a dental emergency and their existing provider is not available, they can contact customer service who will assist them in finding a tele-dentistry provider. Members will not be charged for emergency exams provided via tele-dentistry during the COVID pandemic. Aetna will continue to reassess this policy based on need as circumstances warrant.
• Once the COVID-19 pandemic is over, members will still have access to this tele-dentistry program. Costs for these services will be based on the member’s current benefit plan.
  

Yes. We recommend you follow CDC guidelines regarding routine eye exams, including postponing routine visits.

However, should you need care, lose or break your glasses or require replacement contacts, we recommend calling your provider directly to verify amended store hours or closing. You have 24-hour access to provider contact information via our Provider Locator. You may also call our Customer Care Center directly at 877-973-3238.

You also have the option of utilizing online in-network options through glasses.com, contactsdirect.com, ray-ban.com, lenscrafters.com, and targetoptical.com. Your Aetna benefits will automatically be applied during checkout, and your glasses or contacts will be mailed directly to your home. Many of these online providers are offering free, expedited shipping and no-cost returns for extra convenience. Check with online providers to verify available offers.

We recommend first contacting your provider to discuss your options. While many states do regulate the expiration timeframe for prescriptions, most providers have the discretion to extend them as they deem necessary.

If you are unable to reach your provider and you need glasses or contacts in the event of an emergency, please contact our Customer Care Center at 877-973-3238. Members may be eligible to receive an emergency pair of replacement Adlens Adjustable Glasses (subject to availability). These temporary, emergency glasses can be adjusted to switch focus for reading, computer and distance.

We are continuing to work closely with the American Optometric Association (AOA) and state optometric departments with the goal of providing prescription relief, and we are actively monitoring Department of the Interior (DOI) orders as they relate to vision. Updates will be made available as we have them.

Note: Regulations have already been changed to allow Medicare members to use expired prescriptions during the outbreak. Medicare members will need to contact the provider they last visited for replacement materials. 

At this point in time routine exams still require an in-person office visit.

We encourage you to contact your optometrist’s office directly to determine if your condition qualifies as an emergency. If so, they will provide instructions on what to do. 

Aetna is here to make things easier for you by providing you with different service options. Our Customer Care Center is available during normal business hours at 877-973-3238 for information on nearby in-network providers and any changes to their hours of operation.

24/7 service is available via aetnavision.com through our mobile app (available on both iPhone and Android). Use these tools to access to provider contact information, your benefits, eligibility and more.

Yes. If your plan includes a health screening benefit and it hasn’t been used yet this year, you can use the benefit for COVID-19 testing if needed. The claim can be filed the same way as any other health screening benefit. Aetna will pay claims received after March 1, 2020, regardless of the date of service. COVID-19 will also remain on our list of covered health screening benefits.

Please see below for each plan:

• The Aetna Hospital Indemnity Plan includes benefits if you need to be hospitalized due to COVID-19, such as hospital admission and daily stay.
• The Aetna Accident Plan covers accidents and therefore does not pay benefits for COVID-19 or any other illness, unless the plan includes the inpatient sickness rider.
• The Aetna Critical Illness Plan does not include COVID-19 as a covered condition. However, if a covered condition occurs while being treated for COVID-19, these benefits will cover that condition.

Yes. Aetna's Accident plans include coverage for Telemedicine visits either as a specific Telemedicine benefit (newer Accident plans) or as an Initial or Follow-up Office Visit benefit (older Accident plans).

Yes, Aetna will waive the timeframe for care a member receives related to an accident that’s postponed due to COVID-19. Member must be covered at the time of care and care must be received by December 31, 2020.

The Aetna Fixed Indemnity Plan includes benefits if you need care and treatment related to COVID-19, such as hospital admissions, daily stays, office visits, telemedicine visits, diagnostic testing, x-ray and laboratory services.