As you age, having dental, vision and hearing care is vital to your total health and well-being.Neglecting theseareasmaybelinkedto other health problems,such asheartissues, dementia, depression and increased risk of falls.
One majorbenefitof Medicare Advantage (MA) is that many plans offer coverage for your eyes, ears and teeth. Original Medicare, on the other hand, does not cover any routine hearing, vision or dental care. And that can get to be expensive.For many MA plans, these benefits are already included in the plan’s premium — the amount you pay each month for health coverage.
“Hearing, vision and dental care is not only important for your physical health, but can help improve your quality of life and social interactions with family and friends,” says Dr. Alena Baquet-Simpson,Executive Medical Director, Medical Affairs at Aetna.
Aetna MA plans are designed to help empower you to take care of your total health. Read on to learn more about why it’s so important to take care of your dental, vision and hearing health as you age.
Hearing care
Hearing loss in older adults
Hearing loss is associated with increased risk of social isolation, dementia and depression.
Socialisolation
Dementia
Depression
Hearing loss in older adults
Hearing loss is associated with increased risk of social isolation, dementia and depression.
Socialisolation
Dementia
Depression
Hearing loss can have many physical and mental health impacts. With difficulty hearing, you may be unable to participate in conversations with family and friends. And you may avoid daily activities such as going out to the store or social events. This social isolation can eventually lead to depression.
Impaired hearing isalso stronglylinkedtoanincreased risk of dementia, includingAlzheimer’s disease.Some studies have shown thatcertainareas of the brainthat arelinkedto hearing and communication may shrinkfrom hearing loss.“With dementia, one of the ways you can protect yourself, and maybe slow the onset, is by exercising and stimulating your brain,” says Baquet-Simpson. “But when you have hearing loss, there's potentially less stimulationtothe brain.”
Understanding hearing benefits
Hearing
What’s covered:
Many MA plans cover an annual hearing exam and hearing aid fitting at no extra cost.
How it works:
For network plans, you are required to choose a health care provider within a network of providers. With direct member reimbursem*nt (DMR) plans, there are no network requirements. And you’re given an annual allowance to spend on hearing aids.
Understanding hearing benefits
Hearing
What’s covered:
Most of our MA plans cover an annual hearing exam and hearing aid fitting at noextracost through a network provider.
How it works:
Most of our plans have teamed up with NationsHearing to provide hearing exam and hearing aid benefits. You must schedule your appointment through NationsHearing. Otherwise, your hearing aids will not be covered.
If you havehearing issues, it’s important to get treatment. Hearing aids may prevent some of these health risks and helpyoubetter interact with loved ones.ManyMA plans include coverage for hearing exams and an annual allowance to help cover the cost of hearing aids.
Vision care
Why vision health is connected to your total health
Vision loss is linked to a higher risk of falls, dementia and depression.
Falls
Dementia
Depression
Why vision health is connected to your total health
Vision loss is linked to a higher risk of falls, dementia and depression.
Falls
Dementia
Depression
As you age, you are at higher risk for vision problems such as age-related macular degeneration (AMD), cataracts, diabetic retinopathy, glaucoma and dry eye. You may also experience problems with seeing objects up close (farsightedness) and needing more light to see more clearly.
Vision loss in older adults is linked to increased risk of falls, dementia and depression. It affects your ability to take part in daily activities such as driving, reading the newspaper or watching television. By losing independence, you may be at higher risk for social isolation and depression. Vision loss can also impact your depth perception and balance, putting you at higher risk for falling.
Understanding vision benefits
Vision
What’s covered:
ManyMA plans cover an annual vision exam at noextracost.
How it works:
With some plans, you can see any eye doctor within a network of providers.
For direct member reimbursem*nt (DMR) plans, there are no network requirements. And you’re given an annual allowance to spend on frames, lenses or contacts.
Understanding vision benefits
Vision
What’s covered:
ManyMA plans cover an annual vision exam at noextracost.
How it works:
With some plans, you can see any eye doctor within a network of providers.
For plans with a direct member reimbursem*nt (DMR) benefit, there are no network requirements and you’re given an annual allowance to spend on prescription frames, lenses or contacts.
Original Medicare may cover certain services related to cataract surgery, macular degeneration, glaucoma and diabetic retinopathy, but it does not cover routine eye care. Many MA plans, however, offer coverage for an annual eye exam, as well as prescription glasses and contacts. Regular eye exams are important to help identify health problems earlier and to maintain your vision.
Dental care
The importance of dental health
Tooth loss can impact your ability to…
Speak
Socialize
Eat
Untreated gum disease is linked to other health conditions, such as…
Cardiovascular disease
Rheumatoid arthritis
The importance of dental health
Tooth loss can impact your ability to…
Speak
Socialize
Eat
Untreated gum disease is linked to other health conditions, such as…
Cardiovascular disease
Rheumatoid arthritis
Good oral health is also connected to your overall physical and mental health.Studies have shown that gum disease is closely associated with higher risk of heart disease and rheumatoid arthritis.Untreated gum disease may increase inflammation in the body, which can lead to damagetoother tissues and organs.
Maintaining healthy teeth also helps you eat a well-balanced diet.If you haveextensive tooth loss, youare less likely to eat nutritiously. That’s because you havedifficulty chewing certain high-fiber foods such as fruits and vegetables. Studies have shown that older adults with poor oral health are more likely to be underweight or obese. Tooth loss can also impact a person’s ability to speak, and it can lead to social isolation.
Understanding dental benefits
Dental
Many MA plans offer three types of dental benefits:
Network coverage
Included withintheplan:Yes
What’s covered:
Preventive services (cleaning, X-rays, exams)may becovered at 100%.
For comprehensive services, youmaypay a portion of the cost (coverage varies by plan).
How it works:
You must see a dental care provider within the network of approved providers.*
Direct member reimbursem*nt allowance
Included withintheplan:Yes
What’s covered:
All dental services (except for teeth whitening).
How it works:
You’re given an annual “allowance” to spend on dental care.You pay up front for your care and submit itemized receipts for reimbursem*nt. There areno network requirements.
Optional supplemental benefits
If your plan doesn’t include dental coverage, or you want to increase your coverage, you may have the option to purchase dental benefits with an additional monthly premium.
How it works:
Same as network coverage. You must see a dental care provider within the network of approved providers.*
*Some PPO plans allow you to see a dentist outside of the network, but these services will cost you more.
Understanding dental benefits
Dental
Many MA plans offer one of three types of dental benefits:
Network coverage
Included withintheplan:Yes
What’s covered:
Preventive services (cleaning, X-rays, exams)may becovered at 100%.
For comprehensive services, youmaypay a portion of the cost (coverage varies by plan).
How it works:
You may need to see a dental care provider within our network ofproviders.*
Direct member reimbursem*nt allowance
Included withintheplan:Yes
What’s covered:
You can use the allowance toward almost all dental services except for teeth whitening and a few administrative costs (e.g., missed appointments).
How it works:
You’re given an annual “allowance” to spend on dental care. You pay the provider for services at the time you get care and send us information like a receipt and reimbursem*nt form to get reimbursed. You can see any licensed provider.
Optional supplemental benefits
If your plan doesn’t include dental coverage, or you want to increase your coverage, you may have the option to purchase dental benefits with an additional monthly premium.
How it works:
Same as network coverage. You must see a dental care provider within our network of providers.**
*Some HMO-POS and PPO members with Total Choice Dental benefits can also see dentists that are not part of the Aetna Dental PPO Network. Check the Evidence of Coverage (EOC) for more information.
**Some PPO plansallow you to see a dentist outside of the network, but these services will cost you more.
By regularly seeing a dentist for checkups and maintaining good oral hygiene,you can preventmany of these issuesor you can get treatment for them.ManyMA plans offer some form of dental coverage, including annual exams, cleanings, X-rays and fillings. Some plans offer more comprehensive coverage for dental services such as dentures and root canals.
If you neglect one area of your health, such as hearing, vision or dental care,itcan have a wider impact on your overall well-being. But with additional benefitsto fit your needs,theremay be anMA planthatcan help you care for your total health and achieve your best quality of life.
Disclaimer
Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. The provider network may change at any time. You will receive notice when necessary. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.
About the author
Sachi Fujimoriis a writer and editor based in Brooklyn who focuses on writing about science and health. A good day is one where she eats her vegetables and remembers to live in the moment with her baby girl.
