In 2020 once you and your plan provider have spent $4020 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Aetna Medicare plan does offer additional coverage through the gap. For providers with standard fee schedules, telephone-only services 99441 – 99443, when rendered between March 5, 2020 and September 30, 2020, were typically set to equal 99212 – 99214 (e.g. 99441 was set to equate to 99212).
2021 Biweekly rates for zip code
These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
| Open Access® HMO - Basic | Code | Non-Postal | Postal 1 | Postal 2 |
|---|
2021 benefits
(for a 30-day supply at a retail pharmacy)
| Plan Details | Basic Option |
|---|---|
| Preventive care copay | $0 |
| Primary care visit copay | $15 |
| Specialist visit copay | $35 |
| Maternity | |
| Prenatal Care | $0 |
| Hospital Care | We pay 80% / You pay 20% |
| Inpatient hospital charges | We pay 80% / You pay 20% |
| Surgery and Anesthesia | We pay 100% / You pay nothing |
| Facility Charges | We pay 80% / You pay 20% |
| Outpatient surgery copay | $750 |
| Emergency room copay | $250 |
| Urgent care center copay | $100 |
| Lab/X-ray/diagnostic services | $15 PCP / $35 specialist ($75 for certain tests) |
| Prescription drug copays | |
| Generic formulary* | $5 |
| Brand-name formulary* | $35 |
| Non-formulary* | $100 |
For specialty drug information, see the federal plan brochure. | |
| Built-in Vision | |
| Routine eye exam copay | $35 |
| Money toward prescription eyewear | You get $200 every 24 months |
| Discounts on eyeglasses, contacts, eye exams and more | Included |
Built-in dental, too
Use our Basic Dental Network. Call 1-800-537-9384 to select a dentist OR to switch to our larger PPO network at no additional cost. It's your choice!
Basic - Pay a $5 copay for cleanings, fillings and X-rays when you visit your primary care dentist (PCD).
PPO - After a $20 deductible per member, cleanings, fillings, and X-rays are covered at 100% with network dentists.**
- Large nationwide Aetna HMO Network
- 24/7 access to doctors via phone or video with Teladoc®†
- Built-in dental and vision coverage
- Predictable costs
- No referrals to network specialists*
- Discounts on eyewear, LASIK surgery, gym memberships, massage, acupuncture, weight-loss programs and more
*A formulary is a list of generic and brand-name drugs your health plan prefers.
** Out of Network for cleanings, composite fillings and X-rays – you pay 50% of negotiated rate plus any difference between our allowance and the billed amount.
*** If you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the difference between the generic and brand name costs. Please see the plan brochure for details.
†Teladoc® is covered at the member cost share.
] Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services.
Health insurance plans are offered, underwritten and/or administered by Aetna Life Insurance Company (Aetna).
This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as precertification, step therapy, and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Discount programs are neither offered nor guaranteed under our contract with the FEHB Program, but are made available to all enrollees and their families who become members under an Aetna Health Insurance Plan. Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor. Information is believed to be accurate as of the production date; however, it is subject to change.
Postal and Non-Postal rates
- Non-Postal rates apply to most non-Postal employees.
- Postal rates apply to United States Postal Service employees.
- Postal Category 1 rates apply to career bargaining unit employees represented by the APWU, IT/AS, NALC and NPMHU.
- Postal Category 2 rates apply to career bargaining unit employees represented by the PPOA.
- Non-Postal rates apply to all career non-bargaining unit Postal Service employees and career employees represented by the NRLCA agreement.
New Hires have 60 days to choose benefits.
Sign up at www.benefeds.com or call 1-877-888-3337.
- $300 to spend on frames with our High Option and $150 for Standard Option
- Large, nationwide network including online ordering options
- Lower premiums for 2021
2021 Biweekly rates
| Aetna Vision | Self Only | Self + 1 | Self & Family |
|---|---|---|---|
| Standard | $3.09 | $6.18 | $9.27 |
| High | $5.61 | $11.20 | $16.81 |
2021 Monthly rates
| Aetna Vision | Self Only | Self + 1 | Self & Family |
|---|---|---|---|
| Standard | $6.70 | $13.39 | $20.09 |
| High | $12.16 | $24.27 | $36.42 |
Benefit and cost comparisons (see the difference)
| You Pay*** | ||
|---|---|---|
| Key benefit features in the Aetna network | Standard option | High option |
| Routine eye exam | $0 | $0 |
| Frames BONUS: You'll also get an additional 20% off any balance over the frame allowance. Frame choices aren't limited to frame towers or collections. | You get $150 allowance once every calendar year | You get $300 allowance once every calendar year |
| Standard Plastic Lenses — single, bifocal, trifocal, lenticular once every calendar year in lieu of contacts | $10 | $0 |
| Standard progressive lenses | $75 | $0 |
| Most premium progressive lenses | $95 – $120 | $40 - $65 |
| Standard Polycarbonate lenses; scratch coating | $0 | $0 |
| UV treatment; tint | $15 copay for each | $0 |
| Most Anti-Reflective Coatings | $45-$68 | $20-$43 |
| Contacts BONUS: Receive an additional 15% off any balance over the allowance on conventional contact lenses once every calendar year in lieu of eyeglass lenses | You get $150 | You get $150 |
| Standard Contact Lens Fit and Follow-U | $40 fixed discount** | $40 fixed discount** |
| Premium Contact Lens Fit and Follow-Up | 90% of retail price | 90% of retail price |
Other Aetna plan advantages
- No deductible to meet - the plan starts paying right away
- No limit on your choice of frames
- No limit on what brand of contact lenses network providers can prescribe - you get maximum benefits no matter which brand you choose
- Aetna Vision Preferred mobile app – download for free! And easily find a provider, view your ID card, get benefit information and answers to frequently asked questions
- Members-only special offers are available on aetnavision.com!
- Award winning customer service 7 days per week
- Welcome kit mailed to your home with 2 ID cards
- You can use your flexible spending account (FSA) or health savings account (HSA) toward your out–of-pocket expenses
- International travel solution – we’re ready to help if a vision emergency sneaks up on you when traveling abroad
Go practically anywhere for eye care
With Aetna Vision Preferred, you can see any provider you want, in the Aetna network or out. But remember, network providers will cost you less.
Choice, convenience, flexibility
We know you live busy lives, that’s why our network includes providers with convenient evening and weekend hours. You can receive care from any of our 110,000 providers including top retailers like:
You can also apply your benefits online at any of the below retailers:
Why pick Aetna Vision Preferred?
Video Transcript
Aetna Vision Preferred Plan
Text on screen: Rick Tapnio. Retired Air Force. Current Aetna Employee. Aetna Vision Preferred Member.
Aetna Copay 2020 Application
Rick Tapnio: (00:03) What I love about the Aetna Preferred Vision Plan is choice, savings and convenience. That really narrows down the three most important things for myself and my family simply because we just, we didn't have that before on the plan that we had.
Text on screen: Vision plans can help keep an eye on your health.
Text on screen: John Lahr. Optometrist.
John Lahr: (00:20) Statistics show that close to four times as many people receive a comprehensive eye exam annually as compared to a physical. If they can't see that will drive them in to an optometrist or ophthalmologist to get their eye exam, maybe through a vision plan. We really look at the person in total as we're really trying to assess what's going on, not only with their eyes but what relates from their body into the eyes. Sometimes we can see it in the eye or maybe we're just looking for something that they gave us a hint on medication that we should be assessing, whether it be high blood pressure, high cholesterol, or even diabetes, both type one and type two.
Text on screen: Plans that fit your needs.
Text on screen: Sarah Marbach. Senior Business Consultant. Aetna.
Sarah Marbach: (01:01) One of the things that people most often ask is, 'Which plan is going to be the best for me?' And there's no really easy answer to that question. So, that's really where it comes in, trying to focus in on what do you personally and your family need from a plan? When it comes to vision insurance, do you wear glasses? Do you wear contacts? Are you just going for your annual exam? What kind of extra features are you looking for in your plan? What's your budget like? All those types of things are going to be important factors when you're looking at different options. What's really great about Aetna's plans is that there's a plan for every type of need out there.
Text on screen: Savings
Rick Tapnio: (01:41) Without the cost savings from the Aetna Preferred Vision Plan, I would have paid hundreds more for these frames.
Text on screen: Convenience.
Rick Tapnio: (01:50) Being part of the Aetna vision plan truly allows myself to plan around my busy schedule, around my busy family schedule. I have children that are in school and when we have to make appointments for their eyecare, it usually was during work hours and it was really challenging to do that. But now I know that I can pick up the phone and make an appointment after 5:00 PM or 6:00 PM or on the weekends and make sure that my family's taken care of.
Text on screen: Choices
Sarah Marbach: (02:20) Our provider network is pretty large. We have over a hundred thousand providers nationwide, so you've got a really wide choice when it comes to what eye doctor you want to go see. We're constantly working to make sure that our benefits are top of the line for our customers.
Rick Tapnio: (02:34) I would absolutely recommend the Aetna Preferred Vision Plan to a friend or family, simply because it was the best choice for myself and my family. We looked around, you should too, and at the end of the day, you'll know it's the right one for you as well.
Text on Screen: AetnaFedsLive.com. Connect live to find out which plan works for you.
Disclaimer: The testimonials, statements and opinions expressed on this website are individual experiences, reflecting real life experiences of those who have used an Aetna product and/or service. All such accounts were voluntarily provided without compensation. The testimonials, statements and opinions are not necessarily representative of all of those who will use an Aetna product and/or service.
Enroll today at benefeds.com or call 877-888-3337.
*Internal database as of August 2020.
Aetna Medicare Ppo Plans 2020
**The amount shown is the negotiated discounted price you will pay the provider. Discounts may not be available in all states at all in-network providers. To see a list of providers who do honor discounts, go to directly to www.aetnavision.com , select Find a Provider, and if you see 'May not accept all additional plan discounts' you should contact the provider to confirm.
***Please refer to the plan brochure in Section 4, Your Cost for Covered Services, for the nationwide reimbursement schedule and Section 6, International Services and Supplies, for the international reimbursement schedule.
Vision insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Certain claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care, LLC ('EyeMed').
Aetna Medicare Advantage Plans 2020
This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the plan’s applicable federal brochure(s). All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure. This material is for information purposes only. Providers participating in the Aetna Vision Network are contracted through EyeMed Vision Care, LLC (EyeMed). EyeMed and Aetna are independent contractors and not employees or agents of each other. Participating vision providers are credentialed by and subject to the credentialing requirements of EyeMed. Aetna does not provide medical/vision care or treatment and is not responsible for outcomes. Aetna does not guarantee access to vision care services or access to specific vision care providers, and provider network composition is subject to change without notice. Not all vision services are covered. Discount offers provide access to discounted services and are NOT insured benefits. Lens coverage can be used once every benefit period to purchase either one pair of eyeglass lenses throughout benefit period. Exam coverage and frame coverage can be used once every benefit period. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to aetnafeds.com/vision.