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Many of our Medicare plans include dental, eyewear and hearing benefits. Compare our plans and find the coverage that’s best for you.
Dental, eyewear and hearing coverage is offered through a network plan or as a direct member reimbursement (DMR). You can find specific plan information in the Evidence of Coverage (EOC).
These plans require you to see a network provider. You may have a different network for medical benefits than for dental, eyewear or hearing services. The EOC can help you find the right network for your plan.
A DMR is an annual allowance to see any licensed provider in the U.S. that has not opted out of Medicare. Members will pay out of pocket and then submit a form to get reimbursed up to the plan’s allowance.
Network plans cover preventive care 100% (such as oral exams, cleanings and X-rays).* Some plans include comprehensive services (such as fillings and extractions).
DMR plans cover most ADA dental codes, including preventive care and comprehensive services. Members will pay out of pocket and then submit to get reimbursed up to the plan’s allowance.
|
Network |
DMR |
|
|---|---|---|
|
Who you can see for care |
Has a separate dental network to use |
Allows you to see any dental provider** |
|
Oral exams |
|
|
|
Routine cleanings |
|
|
|
X-rays |
|
|
|
Fillings |
|
|
|
Extractions |
|
|
|
Teeth whitening |
*** |
*** |
|
Network |
|
|---|---|
|
Who you can see for care |
Has a separate dental network to use |
|
Oral exams |
|
|
Routine cleanings |
|
|
X-rays |
|
|
Fillings |
|
|
Extractions |
|
|
Teeth whitening |
*** |
|
DMR |
|
|---|---|
|
Who you can see for care |
Allows you to see any dental provider** |
|
Oral exams |
|
|
Routine cleanings |
|
|
X-rays |
|
|
Fillings |
|
|
Extractions |
|
|
Teeth whitening |
*** |
*Coverage for the frequency of these services may vary based on your plan.
**Must be a licensed provider in the U.S that has not opted out of Medicare. Providers who opt out of Medicare have chosen not to receive money from the Medicare program for services. This means we can’t reimburse them (or their patients) for care.
***Generally, cosmetic services (such as teeth whitening) are not covered.
Network plans cover one annual routine vision exam. They also include an annual allowance that can be used to purchase eyewear.
DMR plans also get an annual allowance to purchase eyewear. Members will pay out of pocket and then submit a form to get reimbursed up to the plan’s allowance.
|
Network |
DMR |
|
|---|---|---|
|
Who you can see for care |
Has a network of vision providers to use |
Allows you to see any vision provider* |
|
How it works |
Provider submits claim to us |
Member pays up front and submits information to get reimbursed |
|
Routine vision exam |
|
No data available
|
|
Eyewear coverage (glasses/contacts) |
|
|
|
Network |
|
|---|---|
|
Who you can see for care |
Has a network of vision providers to use |
|
How it works |
Provider submits claim to us |
|
Routine vision exam |
|
|
Eyewear coverage (glasses/contacts) |
|
|
DMR |
|
|---|---|
|
Who you can see for care |
Allows you to see any vision provider* |
|
How it works |
Member pays up front and submits information to get reimbursed |
|
Routine vision exam |
No data available
|
|
Eyewear coverage (glasses/contacts) |
|
*Must be a licensed provider in the U.S that has not opted out of Medicare. Providers who opt out of Medicare have chosen not to receive money from the Medicare program for services. This means we can’t reimburse them (or their patients) for care.
Network plans cover one annual routine hearing exam and hearing aid fitting at 100%. They may also include coverage toward the purchase of hearing aids.
DMR plans cover one annual hearing exam and hearing aid fitting at 100% if the provider is in-network. They may also include an allowance to purchase hearing aids. Members will pay out of pocket and then submit a form to get reimbursed up to the plan’s allowance.
|
Network |
DMR |
|
|---|---|---|
|
Who you can see for care |
Has a network of hearing providers to use |
Allows you to see any hearing provider* |
|
How it works |
Member will contact hearing network provider |
Member pays up front and submits information to get reimbursed |
|
Routine hearing exam |
|
No data available
|
|
Hearing aid coverage |
|
|
|
Hearing aid fitting |
|
|
|
Network |
|
|---|---|
|
Who you can see for care |
Has a network of hearing providers to use |
|
How it works |
Member will contact hearing network provider |
|
Routine hearing exam |
|
|
Hearing aid coverage |
|
|
Hearing aid fitting |
|
|
DMR |
|
|---|---|
|
Who you can see for care |
Allows you to see any hearing provider* |
|
How it works |
Member pays up front and submits information to get reimbursed |
|
Routine hearing exam |
No data available
|
|
Hearing aid coverage |
|
|
Hearing aid fitting |
|
*Must be a licensed provider in the U.S that has not opted out of Medicare. Providers who opt out of Medicare have chosen not to receive money from the Medicare program for services. This means we can’t reimburse them (or their patients) for care.
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