Dental, Vision & Hearing

Dental

Don’t worry, CareSource Medicare Advantage also covers your smile. No matter which plan you choose, preventive dental services have $0 copay.

Enhanced coverage for our CareSource Advantage® (HMO) and CareSource Advantage Plus® (HMO) plans also include dentures! No deductible, no waiting period!

2019 Dental Coverage

 CareSource Advantage® Zero Premium (HMO)CareSource Advantage® (HMO) Caresource Advantage Plus® (HMO)
 $1,000 Annual Limit For Comprehensive$1,200 Annual Limit for Comprehensive
 Covered/
Not Covered
Copay/
Coinsurance
Covered/
Not Covered
Copay/
Coinsurance
Covered/
Not Covered
Copay/
Coinsurance
Preventive Dental Visits, including Oral Exams*, Preventive Dental Prophylaxis* and Preventive Dental X-Rays**Covered$0 copayCovered$0 copayCovered$0 copay
Preventive Dental Fluoride TreatmentNot CoveredNot CoveredNot Covered
Comprehensive Dental (Medicare Covered) Covered$50 copayCovered$50 copayCovered$30 copay
Comprehensive Dental (Non-Medicare Covered)Not CoveredCovered50% coinsurance, $1000 limitCovered50% coinsurance, $1,200 limit
Lab and Other TestsNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%
Emergency (Palliative)Not CoveredCovered$0 / 50.0%Covered$0 / 50.0%
Space MaintainersNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%
Simple ExtractionsNot CoveredCovered$0 / 30.0%Covered$0 / 30.0%
Surgical ExtractionsNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%
Oral SurgeryNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%
AnesthesiaNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%
Minor Restorations
(e.g., Fillings)
Not CoveredCovered$0 / 30.0%Covered$0 / 30.0%
Major Restorations
(e.g., Crowns)
Not Covered– Covered$0 / 50.0%Covered$0 / 50.0%
Periodontics(e.g., Soft Tissue Procedures)Not CoveredCovered$0 / 30.0%Covered$0 / 30.0%
Endodontics
(e.g., Root Canal)
Not CoveredCovered$0 / 50.0%Covered$0 / 50.0%
DenturesNot CoveredCovered$0 / 50.0%Covered$0 / 50.0%

*Limit 1, Every 6 Months
**Limit 1, Every Year

Vision

CareSource has partnered with EyeMed Vision Care® to bring a Medicare Advantage vision benefit solution that offers more…

  • Access to EyeMed’s Insight network, a vision network made up of the right mix of independent providers, national retail and regional retail providers, including:
    • Independent Provider Network, LensCrafters, Pearle Vision, Target Optical, Sears Optical and JCPenney Optical
  • Service that is always open to new patients and without an appointment

  • Locations with extended evening and weekend hours in convenient locations

  • Online solutions that allow members and their caregivers, to evaluate options at 

    home and reduce stress at the provider office

  • Benefit options that offer more flexibility, choice and savings

2019 Vision Benefits

CareSource Advantage® Zero Premium (HMO)CareSource Advantage® (HMO) CareSource Advantage Plus® (HMO)
Routine Exam with Dilation as Necessary$0 copay$0 copay$0 copay
Exam to Diagnose and Treat Diseases and Conditions of the Eye$50 copay$50 copay$30 copay
$100 allowance per year toward eyeglass frames, eyeglass lenses or contact lenses$130 allowance per year toward eyeglass frames, eyeglass lenses or contact lenses$150 allowance per year toward eyeglass frames, eyeglass lenses or contact lenses
Eyeglass Frames (1 every 2 years)$0 copay; 20% off balance over $100 allowance$0 copay; 20% off balance over $130 allowance$0 copay; 20% off balance over $150 allowance
Eyeglass Lenses
in lieu of contact lenses
$25-$135 copay for most lens types$25-135 copay for most lens types$25-135 copay for most lens types
Contact Lenses (conventional)
in lieu of eyeglass lenses
$0 copay, 15% off balance over $100 allowance15% off balance over $130 allowance15% off balance over $150 allowance

Additional Savings…

  • 40% off additional pair discount

  • 20% off non-prescription sunglasses

  • 15% off retail or 5% off promotional price LASIK

Hearing

CareSource has partnered with TruHearing to provide you with high-quality hearing aids and local professional care at a fraction of the cost. Traditional Medicare doesn’t offer a hearing aid benefit, leaving you to pay $2,000–3,000 per hearing aid on the retail market. Your plan covers up to two hearing aids per year.

2019 Benefits

In-NetworkCareSource Advantage® Zero Premium (HMO)CareSource Advantage® (HMO) CareSource Advantage Plus® (HMO)
Routine Hearing Test

$0 copay$0 copay$0 copay 
Exam to diagnose and treat hearing and balance issues$50 copay$50 copay$50 copay
Hearing aid fitting/evaluation$0 copay$0 copay$0 copay
Hearing Aids$699/999 copay per hearing aid, up to 2 per year$499/799 copay per hearing aid, up to 2 per year$199/499 copay per hearing aid, up to 2 per year

Call TruHearing at 1-855-205-5499 (TTY: 711) to learn more and to find a network provider.