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Dental care, eyewear and hearing benefits

In most cases, Original Medicare won’t cover routine dental, vision or hearing care. Learn how your Aetna Medicare Advantage plan has you covered.

A man and woman looking at a laptop and learning about their Medicare dental, vision and hearing aid coverage

Learn about Medicare Advantage benefits

Want to know more about what’s covered? Take a look at each tab for more on dental, vision and hearing benefits with Aetna Medicare Advantage. Plans can vary. So, you should check your Evidence of Coverage (EOC) for details on your plan.

Dental benefit

 
a tooth to represent Aetna Medicare’s dental network

Aetna® has Medicare Advantage plans with a dental benefit. Many plans cover preventive care. Like oral exams, cleanings and X-rays. We also offer plans with even more dental services. Like fillings and extractions.

How it works

 

Most dental benefits use the Aetna PPO network. That stands for preferred provider organization. See if your dentist is in the Aetna network.

 

Dental benefit

Who you can see for dental care

Oral exams

Covered

Routine cleanings

Covered

X-rays

Fillings

Extractions

Teeth whitening

Teeth whitening is a cosmetic service. It’s not covered.

Dental benefit

Who you can see for dental care

Dental benefit

Oral exams

Covered

Dental benefit

Routine cleanings

Covered

Dental benefit

X-rays

Dental benefit

Fillings

Dental benefit

Extractions

Dental benefit

Teeth whitening

Teeth whitening is a cosmetic service. It’s not covered.

 

Check your Evidence of Coverage for more details on your plan’s benefits.

Vision benefit

 
eye exam chart

Aetna® has Medicare Advantage plans with a vision benefit. It covers one routine vision exam per year. Some plans also include a benefit amount (allowance) each year to buy prescription eyewear.

How it works

 

Plans are offered as a network benefit or as a direct member reimbursement (DMR) benefit.

 

With a network benefit: You can see any vision provider in your plan’s network. See if your provider is in the network.

 

With a DMR benefit: You can see a licensed provider of your choice. You may need to pay out of pocket, first. Then you can file a claim to get paid back up to your plan's benefit amount. Or you can use an Aetna network provider. If you do, they’ll bill us directly. You won't need to file a claim.

 

Visit AetnaMedicareVision.com for a list of network providers.

 

Vision benefit

Network

Direct member reimbursement

Who you can see for vision care

How vision coverage works

Network providers bill us directly.

Pay up front and file a claim. Or see a network provider.

Routine vision exam

Covered

Covered

Eyewear coverage
(glasses/contacts)

Vision benefit

Who you can see for vision care

Network

Direct member reimbursement

Vision benefit

How vision coverage works

Network

Network providers bill us directly.

Direct member reimbursement

Pay up front and file a claim. Or see a network provider.

Vision benefit

Routine vision exam

Network

Covered

Direct member reimbursement

Covered

Vision benefit

Eyewear coverage
(glasses/contacts)

Network

Direct member reimbursement

 

Check your Evidence of Coverage for more details on your plan’s benefits.

 

To file a claim

To file a claim

You may have a DMR plan for your vision benefit. If so, we’ll need some info to process your claim and pay you back. You may need to ask for some of these items during your visit. So be sure to ask for all the information you need while you’re there.

  • A copy of the paid, itemized receipt from the provider, with:
    • The date of service
    • The name of your provider
    • The address of your provider 
    • A brief description of the services or items you need reimbursement for. For example, tooth crown. Or the procedure codes, if any. Submit both the description and the codes if you have them.  
    • Your diagnosis codes
  • 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.

Get a claim form

Hearing benefit

 

 
 an ear to represent a hearing aid fitting covered by Medicare

Aetna® Medicare has teamed up with NationsHearing® to provide hearing benefits. We have Medicare Advantage plans that cover one routine hearing exam per year. And plans that cover hearing aids and one hearing aid fitting per year.

How it works

 

We offer Medicare HMO and PPO plans. These are also known as health maintenance organization and preferred provider organization plans. 

 

With an HMO plan: You can see any NationsHearing provider for a hearing exam.

 

With a PPO plan: You can see any licensed provider for a hearing exam. 

 

Hearing aids are only covered through NationsHearing.

 

Hearing benefit

HMO

PPO

Who you can see for hearing care

See any NationsHearing provider.

See any licensed provider.

How hearing coverage works

Contact NationsHearing to schedule your visit.

Contact your provider or NationsHearing to schedule your visit.

Routine hearing exam

Covered

Covered

Hearing aids

Covered

Covered

Hearing aid fitting

Covered

Covered

Hearing benefit

Who you can see for hearing care

HMO

See any NationsHearing provider.

PPO

See any licensed provider.

Hearing benefit

How hearing coverage works

HMO

Contact NationsHearing to schedule your visit.

PPO

Contact your provider or NationsHearing to schedule your visit.

Hearing benefit

Routine hearing exam

HMO

Covered

PPO

Covered

Hearing benefit

Hearing aids

HMO

Covered

PPO

Covered

Hearing benefit

Hearing aid fitting

HMO

Covered

PPO

Covered

 

Check the Evidence of Coverage for more details on each plan’s benefits.

Questions? We’ve got answers

Member Services

Access resources and contact information that is specific to your plan.

 

Contact Member Services

 

Member FAQs

Explore questions that are commonly asked by our members.

 

See our answers