What the Plan Pays
|Vision CareEye exams||Reimbursements of up to $100 every 12 months for an exam,
frames, lenses, or contact lenses.
|HeaderFees for other services must be paid by you. Benefit period is 12 consecutive months beginning on the later of your effective date or your most recent eye exam covered under this plan.|
|HeaderEyeMed Vision Care Select Network is not available in Puerto Rico.|
|HeaderThis health plan does not meet Massachusetts Minimum Creditable Coverage standards.|
|Vision care exclusions|
|Vision care exclusionsThis plan does not cover all vision care expenses and has exclusions and limitations. Members should refer to their booklet certificate to determine which vision care services are covered and to what extent. The following is a partial list of services and supplies that are generally not covered. However, member’s plan may contain exceptions to this list based on state mandates or the plan design purchased.|
|Vision care exclusions1. Orthoptic vision training, subnormal vision aids, any associated supplemental testing.
2. Medical and/or surgical treatment of the eyes or supporting structure.
3. Any eye or vision examination, or any corrective eyewear, required by an employer as a condition of employment.
What the Plan Costs
|VisionYou + child(ren)||$3.30|
|VisionYou + Spouse||$3.52|
|VIsionYou + Family||$4.90|
What if I miss a payroll deduction?
If you miss a payroll deduction after your coverage begins, you will not have coverage during the time that payroll deduction would cover, unless you pay the full missed premium directly to Aetna Voluntary.
See Missed Premium Payment Coupon for more information!