Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
Aetna VisionSM Preferred
Plan Information
Plan Name: Aetna VisionSM Preferred
Policy Number: 1005417101
Effective Date: 06/01/2025
Provider Network: Aetna VisionSM Preferred
Benefit Highlights
In-Network |
Out-of-Network Reimbursement |
|---|---|
| Exams | Exams |
| $10 | Up to $25 reimbursement |
| Single Vision Lenses | Single Vision Lenses |
| $25 | Up to $10 reimbursement |
| Bifocal Lenses | Bifocal Lenses |
| $25 | Up to $25 reimbursement |
| Trifocal Lenses | Trifocal Lenses |
| $25 | Up to $55 reimbursement |
| Frames | Frames |
| $0 Copay; $130 allowance**, 20% off balance over allowance | Up to $65 reimbursement |
| Contacts (in lieu of glasses) | Contacts (in lieu of glasses) |
| Conventional: $0 copay; $105 allowance, 15% off balance over allowance Disposable: $0 copay; $105 allowance Medically Necessary: Covered in full |
Conventional: $75 reimbursement Disposable: $84 reimbursement Medically Necessary: $200 reimbursement |
Frequency |
Frequency |
|---|---|
| Exams | Exams |
| Once every 12 months | Once every 12 months |
| Lenses | Lenses |
| Once every 12 months | Once every 12 months |
| Frames | Frames |
| Once every 24 months | Once every 24 months |
| Contacts | Contacts |
| Once every 12 months | Once every 12 months |