Adult routine vision exams (including refraction) performed by a legally qualified ophthalmologist or optometrist.
Find a provider:
- Aetna Provider Search
- Enter location and choose miles to “look within”
- Choose Medical network “OA Managed Choice POS” – Do not choose Aetna Vision preferred – you only have a vision benefit under your Medical Plan which is “OA Managed Choice POS”.
- Choose “Medical Doctors & Specialists” to search for an “optometrist” or “ophthalmologist”
- Choose “Medical Specialist”
- From the list (in alphabetic order) choose “optometrist” or “ophthalmologist”
- For Eye Wear, choose “Vision” and then click on Routine vision exams and eyewear – this will take you to another website where you can choose an in-network store to buy frames.
Benefit Information
$30 copayment then the plan pays 100% (of the balance of the negotiated charge)per visit (In-network coverage)
$30 copayment then the plan pays 60% (of the balance of the recognized charge) per visit (Out -of-nework coverage)
Fitting of Contact maximum 1 visit
Eyeglass frames, prescription lenses or prescription contact lenses 80% (of the negotiated charge) per visit (In-network coverage) 60% (of the recognized charge) per visit (Out-of-network coverage)
* For the routine exam, providers should submit the bill to the medical plan. For Eye wear there is a chance that you will have to pay out of pocket and then submit a claim to Aetna Aetna Claim Form
Maximum per policy year - eyeglass frames and prescription lenses $150
Maximum per policy year - prescription contact lenses $75
Detailed information about the vision benefits can be found in the Plan Design and Benefits Summary on page 26.
Separate Vison Coverage can be Purchased through Aetna
Aetna Student Health also offers a Vision Plan. Enrollment and payment for the separate Plan must be completed directly with Aetna.