Dental, Vision, and Hearing Coverage

Visit one of our participating UPMC for Life Dental Advantage providers for the following preventive benefits:

• Two oral exams and cleanings per year
• One bitewing x-ray per year
• One panoramic x-ray every 36 months
• Dental allowance for many dental services, like fillings, tooth extractions, bridges, crowns, and much more — some plans now include DENTURE coverage (not all plans include a dental allowance)
• One comprehensive oral exam every 36 months

Remember, if your plan includes the UPMC for Life Flex Spend Card, you can use it to pay for non-covered services like teeth whitening and dental implants.

In most cases, you are responsible for all other charges beyond preventive care. Preventive care copays and the dental allowance are excluded from the yearly medical deductible, if applicable, and do not count toward the annual maximum out-of-pocket. Copay and dental allowance amounts vary by plan.

Members can see any provider they like, even if the provider is not in our vision provider network. Find a participating vision provider for the following benefits:

• One routine vision exam
• One contact lens fitting
• Routine vision allowance: The routine vision allowance can be used toward the cost of contact lenses or eyewear, including progressive and transitional lens.

How does the routine vision benefit work?

• If routine vision services are received from a participating provider, the vision provider will bill the plan.
• If you receive routine vision services from a nonparticipating provider, you may have to pay the cost of the service at the time of the appointment. You can submit a claim for reimbursement for up to the vision allowance amount for your plan.
• To submit a claim for reimbursement, you will need to complete a vision claim reimbursement form and fax or mail it to us.

The routine vision allowance does not apply to glasses after cataract surgery. It is excluded from the yearly deductible, if applicable, and does not count toward the annual out-of-pocket maximum. Routine vision allowance amounts vary by plan.

Hearing benefits and hearing aid discount

Members enrolled in a plan with hearing coverage get the following benefits:

• One hearing exam per year.
• One hearing aid fitting exam every year.
• $690-$1,890 for one hearing aid per ear per year. You can choose from different types of hearing aids based on quality and cost. To get this important discount, make sure to use an Amplifon hearing provider.

In most cases, you are responsible for all other charges beyond routine care. Hearing care copays and the hearing aid discount are excluded from the yearly deductible, if applicable, and do not count toward the annual maximum out-of-pocket.