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Learn about these benefits
You can find specific plan information in the Evidence of Coverage (EOC).
Direct member reimbursement (DMR)
A DMR is an annual allowance to see any licensed provider in the U.S. You will pay out of pocket and then submit a form to get reimbursed up to the plan’s allowance.
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.
2024 dental benefits
Our Plus, Premier, Grand, Elite, Eagle and Value plans offer dental benefits which allow you to receive dental services, up to the maximum benefit allowance, from an Aetna Dental® PPO network provider or a provider not in our network.
Out-of-network providers are not required to bill us directly, but many will. If they will not bill us directly, you can pay for covered services at the time you get care. Then, send us the information, like a receipt and reimbursement form, to get reimbursed.
To find an Aetna Dental PPO network provider, visit our online directory.
Our SmartFit Plan offers dental benefits through a network which allows you to receive dental services, up to the benefit allowance maximum, from an Aetna Dental® PPO network provider or a provider not in our network.
If you see a network provider, you will pay $0 for preventive services including oral exams, bitewing X‑rays and cleanings; and $0 for comprehensive services including things like fillings, extractions, crowns, root canals, dentures and implants.
If you see an out-of-network provider, you will pay 20% for preventive services including oral exams, bitewing X‑rays and cleanings; and 20% for comprehensive services including things like fillings, extractions, crowns, root canals, dentures and implants. Out-of-network providers are not required to bill us directly, but many will. If they will not bill us directly, you can pay for covered services at the time you get care. Then, send us the information, like a receipt and reimbursement form, to get reimbursed.
To find an Aetna Dental PPO network provider, visit our online directory.
2023 dental benefits
Our plans include our Total Choice Dental benefit, which allows you to receive dental services from an Aetna Dental® PPO network provider or a provider not in our network. If you see a network provider, we have contracted rates with them. That means you get more coverage. If you choose to see a provider not in our network that is willing to bill us directly, you will not be required to submit for reimbursement.
To find an Aetna Dental PPO network provider, visit our online directory.
Note: Out-of-network providers are not required to bill us directly, but many will. If not, you can pay for covered services at the time you get care. Then, send us the information, like a receipt and reimbursement form, to get reimbursed.
Eyewear benefit
Your vision is important to your health and wellness. We pay up to an annual allowance maximum for non-Medicare covered prescription eyewear. You are responsible for any amount above the eyewear coverage limit. Refer to your Evidence of Coverage (EOC) to learn more.
2024 eyewear benefits
By using an EyeMed network provider, you no longer need to pay up front or submit a reimbursement form for prescription eyewear. Your plan covers one annual routine vision exam. It includes an annual allowance that can be used to purchase eyewear.
You may visit any licensed vision provider in the U.S. If you see a provider outside of the EyeMed network, 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
2023 eyewear benefits
You may see any licensed vision provider in the U.S. To be reimbursed for your eyewear, you must complete the medical reimbursement form. See below for instructions for submitting for reimbursement.
Hearing benefit
Your hearing is important to your health and wellness. Because of this, all of our plans include coverage for 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 them 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 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.
More questions? Help is here
Already a member?
Call an Allina Health | Aetna Medicare representative at ${membersPhone} ${tty}, ${membersHours}.