Aetna is a private insurance company that sells Medicare Advantage (Part C) plans. Aetna offers vision coverage in many of its Advantage plans. Your cost will depend on your ZIP code and which plan you choose.
If you wear prescription eyewear, you know the importance of annual vision screenings.
Having a health insurance plan that covers the cost of vision and eye services makes it easy to get the care you need. It means you can schedule routine eye exams and get affordable prescription lenses.
Any Medicare Advantage plan, such as Aetna Medicare Advantage, must offer the same coverage as Original Medicare (parts A and B). This includes both hospital insurance and medical insurance.
Aetna vision coverage offers comprehensive eye services, such as:
- routine eye exams, usually one exam per year
- diabetic retinopathy screenings
- yearly allowance to cover the cost of frames
- annual compensation for prescription or contact lenses
- cataract surgery
Aetna Medicare Advantage plans are available in most U.S. states. You can find the right plan to suit your healthcare needs, including:
- Health Maintenance Organization (HMO) plans
- Point-of-Service (POS) plans
- Preferred Provider Organization (PPO) plans
- Dual Eligible Special Needs Plans (D-SNPs)
Plans can change depending on your state or county. Each program has a distinct yearly allowance, copays, and benefits.
Your costs will depend on your ZIP code and the plan you choose, whether it covers visits to out-of-network professionals and whether there are in-network vision specialists.
You can compare premium rates and additional benefits using Medicare’s plan finder tool. Enter your ZIP code to compare the plans offered in your area.
Here are some sample costs from 2021 for Aetna Medicare Advantage plans with vision coverage:
| City | Plan name | Monthly premium | Out-of-pocket maximum |
|---|---|---|---|
| Columbus, Ohio | Aetna Medicare Premier (HMO) | $0 | $4,900 (in network) |
| Aetna Medicare Premier 1 (PPO) | $140 | $5,500 (in network); 8,950 (in and out of network) | |
| Aetna Medicare Premier 2 (PPO) | $199 | $5,100 (in network); $8,950 (in and out of network) | |
| Houston, Texas | Aetna Medicare Prime Plan (HMO) | $0 | $3,850 (in network) |
| Aetna Medicare Eagle Plan (PPO) | $0 | $5,000 (in network); $8,950 (in and out of network) | |
| Aetna Medicare Value Plan (PPO) | $0 | $7,550 (in network); $11,300 (in and out of network) | |
| Phoenix, Arizona | Aetna Medicare Prime Plan (HMO) | $0 | $2,500 (in network) |
| Aetna Medicare Platinum Plan (HMO) | $0 | $4,800 (in network) | |
| Aetna Medicare Freedom Plan (PPO) | $59 | $500 annual deductible; $3,850 (in network); $5,750 (in and out of network) |
Anyone eligible for Original Medicare is also eligible for Medicare Advantage. You’re eligible for Aetna Medicare Advantage vision coverage if you’re a U.S. citizen or permanent resident over age 65 years.
If you’re under age 65 years, you can apply for Medicare coverage if you have a permanent disability or a chronic illness such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD).
To enroll in a plan with Aetna Medicare Advantage vision coverage, you must first sign up for Original Medicare (parts A and 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, you’re eligible for an Aetna Medicare Advantage plan.
Start your enrollment by determining what Aetna Medicare Advantage plans are available in your area.
Use Medicare’s plan comparison tool to find a list of Aetna vision plans available in your county, along with benefits, vision services, copays, and premiums.
You can also contact Aetna at 855-335-1407.
Here are answers to some commonly asked questions.
Does Original Medicare include vision coverage?
Original Medicare does not offer vision coverage for:
- routine eye exams
- prescription eyewear
- contact lenses
However, Medicare Part B will cover the cost of:
- yearly diabetic retinopathy screenings
- glaucoma tests
- cataract surgery
Part B deductibles will apply, though.
Does Aetna cover vision care?
Aetna Medicare Advantage vision coverage will include yearly eye exams to check your vision and monitor your eye health.
Aetna vision plans also cover frames, prescription, and contact lenses. Aetna provides a yearly allowance for frames and prescription eyewear.
Does Aetna Medicare Advantage cover cataract surgery?
Since Original Medicare covers cataract surgery, Aetna Medicare Advantage plans must also cover this. Make sure to go to doctors and facilities that are in your plan’s network to ensure coverage.
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 what’s in your policy by reading the evidence of coverage statement provided to you by your plan.
If you’re 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.
Vision coverage is a part of many Medicare Advantage plans. Aetna offers Medicare Advantage plans that include vision coverage.
If you’re eligible for Medicare Advantage, you can purchase an Aetna Medicare Advantage plan with vision coverage.