Friday, April 19, 2024

Aetna Medicare Vision Network Providers

How Much Does Aetna Vision Coverage Cost

How To Look Up Doctors On Aetna’s Medicare Network

Your costs will depend on your ZIP code and the plan you choose whether it covers visits to out-of-network providers and whether there are in-network vision specialists.

You can compare premium rates and additional benefits using Medicares . Simply enter your ZIP code to compare the plans offered in your area.

Here are some 2021 sample costs for Aetna Medicare Advantage plans with vision coverage.

Aetna Medicare Premier 1 $140 $11,300
Aetna Medicare Premier 2 $199
Houston, TX Aetna Medicare Prime Plan $0
Aetna Medicare Eagle Plan $0
Aetna Medicare Value Plan $0
Phoenix, Aetna Medicare Prime Plan $0
Aetna Medicare Platinum Plan $0
Aetna Medicare Platinum Plan $59

Information For California Members Only

$ contracts with provider organizations called an Independent Practice Association or a Physician-Hospital Organization . An IPA/PHO is an association of independent providers. It may include hospitals, primary care doctors and specialist doctors, who together provide health care services.

$ uses several IPAs to provide you with health care services. You may choose a primary care physician associated with an IPA/PHO. If you do, theyll refer you for health care services and specialist care within their IPA/PHO.

Do Aetnas Medicare Advantage Plans Include Vision Coverage

Some of Aetnaâs Medicare Advantage plans cover routine vision services. These may include eye exams, glasses, frames, contact lenses, and more. Different Aetna plans have different levels of vision coverage some may not have routine vision coverage.

Did you know that many of Aetnaâs Medicare Advantage plans include prescription drug coverage? Thatâs right â thatâs in addition to the Medicare Part A and Part B benefits you get through a Medicare Advantage plan. You get all Part A and Part B benefits except for hospice care, which Medicare coverage still provides to you directly instead of through the plan.

With a Medicare Advantage plan from Aetna , you might also get additional benefits beyond Part A and Part B. You already know about prescription drug coverage and vision coverage, but did you know some plans may offer routine dental or hearing benefits? Remember that benefits beyond Part A and Part B vary among plans.

When you have an Aetna Medicare Advantage plan , hereâs something you need to know. You still continue to pay your monthly Medicare Part B premium, as well as any premium your Medicare Advantage plan might charge. Some plans may have premiums as low as $0.

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Know Everything Your Vision Plan Covers

Depending on your plan, Aetna Vision Preferred vision insurance generally includes:*

  • One eye exam per year with $0 co-pay

  • Standard prescription eyeglass lenses at a member cost of $0 to $25 with a frames allowance ranging from $130 to $300

  • OR a contact lens allowance from $130 to $150 per calendar year

  • Eyeglass lens extras typically require an additional co-pay. For example: Lenses with an anti-reflective coating or made with an above-standard material are usually less than a $100 co-pay. Progressive lenses cost anywhere from $0 to $135

That means if you use your Aetna Vision plan to help pay for prescription contact lenses and want to also buy a pair of eyeglass lenses during the same 12-month period, your allowance will only cover the first type of eyewear purchased .

After you enroll in an Aetna Vision Preferred plan, youll receive a welcome packet in the mail. The packet includes your member ID card, information about your plan and a list of local in-network providers. Once you have your member ID, you can use your ID number to register an account on the Aetna Vision website.

After you create your account, you can log in and access your vision plan documents online. Review them carefully to ensure you get the most out of your benefits.

*Coverage depends on your individual plan. Please see your vision insurance member documents to determine your specific benefits.

SEE ALSO:What is covered by vision insurance?

What To Expect From Aetna Vision Preferred Plan

Insurance in Brookfield, WI, and the Greater Milwaukee Area

With an Aetna Vision Preferred plan, your vision care is simple. You locate a provider, talk with them about scheduling an appointment and use your benefits to start saving.

There are thousands of providers across the country, including eye doctors in your neighborhood and inside your favorite retail chains. Many providers will offer you weekend and night-time hours.

Aetna Vision also offers you benefits for:

  • Gym memberships

If you are ready to find an Aetna Vision Provider follow these easy steps:

  • Search by Provider
  • Enter your 5-digit zip code and the search engine will take it from there.
  • Filters will narrow your results by listing the brands you recognize and love. It will also provide hours to choose from, the specific technology used by each provider, and more.
  • If you have a favorite eye-care provider, click on the search by name and zip code to look for a specific clinic.

When you choose an Aetna Vision preferred clinic within the network, you will enjoy added savings that include exclusive coupon offers and discounts. Our in-network providers, include LensCrafters, Ray-Ban,, and Target Optical.

  • offers a unique kind of eye care. You can choose from green shipping and natural materials with your eye care. These options help you do your part in reducing climate change. We can offer a variety of lenses, including Blue light, transitions, and prescription sun. Our eyecare service is personalized to meet your needs.

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Schedule Your Annual Eye Exam

Aetna Vision Preferred plans cover one eye exam per year, and its important to take advantage of it. Make an appointment with an eye doctor for a comprehensive eye exam. The eye doctor will check your vision and let you know if you need glasses, contacts or a new prescription.

Your doctor will also examine your eyes, checking their overall health and looking for symptoms of eye conditions such as glaucoma, cataracts and macular degeneration.

In addition to eye health and vision issues, an eye exam can reveal signs of other medical conditions such as diabetes, high blood pressure and heart disease. Symptoms of an aneurysm, stroke or brain tumor, along with numerous other medical conditions, may also be detected during an eye exam.

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Are Video Visits With An Eye Doctor Online Covered By Aetna

Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Eye Doctors who accept Aetna for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.

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How To Use An Aetna Vision Membership

To use your Aetna Vision membership, find an in-network eye doctor through the above provider locator and schedule an appointment.

When you arrive at your appointment, you will answer their check-in questions, pay any co-pay due and the doctor will finish the rest of your membership claim.

Submitting a claim for your eyecare through Aetna Vision is done through your doctor. All the paperwork is submitted by the physician if you use an in-network provider.

If you require progressive lenses, these are categorized in different tiers. Check your membership account to learn what your plan covers for the different tiers.

If Youre Enrolled In An $ Medicare Plan

2023 Aetna MAPD Sales Presentation

You have the flexibility to receive covered services from network providers or out-of-network providers. Out-of-network/non-contracted providers are under no obligation to treat $ Medicare members, except in emergency situations.

You may want to know if know if your plan will cover an out-of-network service. If so, you or your provider can ask us for a pre-service organization determination. If you do, well let you know if your plan covers the service. Please call us or see your Evidence of Coverage for more information, including the cost share for out-of-network services.

In most plans you dont have to choose a primary care physician. However, we encourage you to do so. If you receive covered services from an out-of-network doctor, its important to confirm that they:

Other pharmacies, physicians and providers are available in our network.

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If Youre Enrolled In $ Medicare Plan Open Access

Youre not required to choose a primary care physician . You dont need a referral to visit network providers to receive covered services. Although youre not required to select a PCP, we encourage you to do so.

Your plan requires you to use network providers, except for:

  • Emergency or urgent-care situations
  • Out-of-area renal dialysis

If you get care from an out-of-network provider, your plan wont cover their charges. Medicare and Aetna Medicare wont be responsible either.

What Is Prior Authorization And When Do You Need It

Certain network health care services, such as hospitalization or outpatient surgery, require prior authorization from $ Medicare. This means that $ Medicare must approve the service before the plan will cover it. Check your Evidence of Coverage for a list of services that require prior authorization.

If you need services that require prior authorization, have the network provider contact us. The provider is responsible for getting prior authorization from $ Medicare before treating you.

Some plans include an out-of-network benefit. If yours does and you decide to receive covered services from an out-of-network provider, ask the provider to contact us for prior authorization for those services.

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How Can I Book An Appointment Online With An Aetna Eye Doctor

Zocdoc is a free online service that helps patients find Aetna Eye Doctors and book appointments instantly. You can search for Aetna Eye Doctors by symptom or visit reason. Then, choose your location. Based on that information, youll see a list of providers who meet your search criteria, along with their available appointment slots.

How Can You Find An Aetna Medicare Advantage Plan

Aetna Insurance Plans Dental

If youâve decided that youâd like to browse through Aetnaâs Medicare Advantage plans in your vicinity and check out their benefits, all it takes is for you to enter your ZIP code in the box on this page. Contact eHealth if youâd like to speak with one of our licensed insurance agents.

Aetna Medicare coverage is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Y0001_4009_17090_M Accepted 08/2019

Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealthâs Medicare related content is compliant with CMS regulations, you can rest assured youâre getting accurate information so you can make the right decisions for your coverage.Read more to learn about our Compliance Program.

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Whos Eligible For Aetna Medicare Vision Coverage

Youre eligible for Aetna Medicare Advantage vision coverage if youre a U.S. citizen or permanent resident over age 65.

If youre under age 65, you can apply for Medicare coverage if you have a permanent disability or a chronic illness such as amyotrophic lateral sclerosis or end stage renal disease .

To enroll in a plan with Aetna Medicare Advantage vision coverage, youll first need to sign up for original Medicare. Original Medicare is made up of Part A and Part B .

Contact Social Security and enroll in original Medicare online, over the phone, or by visiting your local office. After you have your Medicare number, youre eligible for an Aetna Medicare Advantage plan.

How Much Does An Aetna Medicare Advantage Plan With Vision Coverage Cost

As with most Medicare Advantage plans, the cost of a Medicare Advantage plan from Aetna may vary according to location, benefits offered and other criteria.

You can use the Medicare Plan Finder tool to see how much an Aetna Medicare Advantage plan with vision benefits might cost in your area.

The following table provides some examples of what you might pay for an Aetna Medicare Advantage plan with vision coverage in Miami-Dade County in Florida and Maricopa County in Arizona.

Aetna Medicare Vision Coverage

40% coinsurance for out-of-network exams all other copayments $0

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When You Need Emergency Care

If you need emergency care, youre covered 24 hours a day, 7 days a week, anywhere in the world. Whether youre in or out of an $ Medicare service area, please follow these guidelines when you think you need emergency care:

  • Notify your PCP as soon as possible after you get treatment.
  • Notify your PCP or $ Medicare as soon as possible if youre admitted to an inpatient facility.

If You Travel Outside Of The $ Service Area

Aetna Vision Preferred Member Testimonial

Youre covered for emergency and urgently needed care. You can always get emergency care from the closest available provider, in or out of the service area. HMO plan members must use providers in their network service area for urgent care, unless these providers arent available. When youre out of the service area, you can get urgent care from the first available provider.

You can get urgent care from:

  • An urgent care center or an emergency facility

Well review the information that the provider who supplied your care submits to us. We may need more information if the nature of the urgent or emergency issue doesnt qualify for coverage.

Some plans offer a visitor/traveler benefit. Under our visitor/traveler program you may receive all plan covered services at in-network cost-sharing when you see a network provider. PCP and referral rules still apply. You must select a PCP in the visitor/traveler area in order for your plan to cover those services.

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Can I Add Vision To My Aetna Medicare Advantage Plan

Many Aetna Medicare Advantage plans include routine vision and eye services. You can find out precisely whats in your policy by reading the evidence of coverage statement provided to you by your plan.

If youre enrolling in an Aetna Medicare Advantage plan for the first time, check which vision and eye services each plan offers and compare them to get what you need.

If you select a policy without vision coverage, you may be able to add an optional supplemental benefit to receive it.

How Can I Find A Top

You can use Zocdoc to find Aetna Eye Doctors who are highly rated by other patients. These ratings are based on verified reviews submitted by real patients. Every time a patient completes an appointment booked on Zocdoc, theyre invited to review their experience. Each review must comply with Zocdocs guidelines.

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Our Eye Care Staff Is Here To Help You With Your Insurance

If you do not see your plan listed here, please give us a call and we would be happy to assist you. Our staff is also always available to answer any questions regarding your benefits.

The cost of routine eye exams and prescription eyewear can be of real concern, especially for large families. In many cases, vision insurance can lower these annual expenses.

A vision insurance policy is not the same as medical insurance. Regular medical health insurance plans protect you against financial losses due to unexpected eye injuries or disease. Vision insurance, on the other hand, is a wellness benefit designed to provide routine eye care, prescription eyewear and other vision-related services at a reduced cost.

Generally You Must Get Your Health Care Coverage From Your Primary Care Physician

Does Aetna Medicare Cover Eye Exams

Your PCP will issue referrals to participating specialists and facilities for certain services. For some services, your PCP is required to obtain prior authorization from $ Medicare.

Youll need to get a referral from your PCP for covered, non-emergency specialty or hospital care, except in an emergency and for certain direct-access service. There are exceptions for certain direct-access services.

You must use network providers, except for:

  • Emergency or urgent care situations
  • Out-of-area renal dialysis

If you get routine care from out-of-network providers, Medicare and $ Medicare wont be responsible for the costs.

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Aetna Plan Options And Costs

Aetna offers a select number of Medicare Supplement plans. Although the company does not have the full suite of Medigap policies, its prices are extremely competitive when looking at the market as a whole. It is important to note that what each Supplement plan covers is standardized across the nation and across each company. This means, for example, that Medicare Supplement Plan A from Aetna will cover the same services as Plan A from AARP/UnitedHealthcare. We have outlined what each plan covers below:

Plan A

You’ll notice that Aetna only offers plans A, B, F, G and N for Medicare Supplement. This means that if you are looking for one of the other policies available , then you will need to find a different Medigap insurer. This is especially important to notice since Plan F is no longer available to new enrollees in Medicare, making Plan G a great overall choice for most individuals that want complete coverage.

About The Providers In This Directory

The $ network providers in this directory have agreed to provide you with your health care services. You may go to any of these network providers. However, some services may require a referral.

In some cases, you may get covered services from out-of-network providers, but you may pay more out of pocket.

For some plans, you may have to choose one of our network providers to be your primary care physician .

You can also find a list of pharmacies that offer Part B and Part D drugs in our pharmacy directory. Check with your pharmacy to see if they offer the services you need to fill a prescription.

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