Aetna Medical Insurance: What You Should Know Before Your Eye Exam
- Dr. Ryan Corte
- 2 days ago
- 4 min read
Are you interested in learning more about Aetna medical insurance? Maybe you already have Aetna and are looking for an eye doctor in Charlotte or Asheville, NC.
If so, look no further, Reflect Vision Care proudly accepts Aetna medical insurance! We also accept a wide range of vision and medical insurance plans, helping you receive high-quality eye care while making the most of your benefits.
Below, we’ve answered the most common questions our patients ask about Aetna and how your plan can be used for medical eye exams, diabetic evaluations, and other eye health services.
What Is Aetna Medical Insurance?
Aetna, founded in 1853, is one of the nation’s leading health insurance providers, now part of the CVS Health family. Aetna offers medical coverage to more than 39 million members across the United States, including employer-sponsored plans, Medicare Advantage plans, and individual coverage.
Aetna’s mission is simple: to build a healthier world by making healthcare simpler and more accessible for everyone.
When it comes to eye care, Aetna covers medical eye exams for conditions affecting your eye health, such as glaucoma, cataracts, diabetic eye disease, and dry eye. Many Aetna plans also include vision benefits through partner networks like EyeMed.
How to Find an Aetna Eye Doctor
Finding an Aetna provider is simple. You can locate in-network eye doctors by visiting the Aetna Provider Directory and searching by:
ZIP code or city
Doctor or practice name
Specialty (Optometry or Ophthalmology)
💡 Tip: Aetna distinguishes between medical eye exams (covered under your health plan) and routine vision exams (covered under a separate vision plan). At Reflect Vision Care, we’ll help you determine which applies to your visit before your appointment.
And yes, Reflect Vision Care proudly accepts Aetna medical insurance!
What If My Provider Isn’t In-Network?
You can still visit any eye doctor you choose, but if your provider is out-of-network, you may need to pay upfront and submit a claim to Aetna for reimbursement.
Your reimbursement amount depends on your specific plan, deductible, and out-of-network benefits.
Our Reflect Vision Care team can verify your coverage in advance and explain whether your visit will be billed as medical or vision, so you know exactly what to expect.
How Much Does Aetna Insurance Cost?
The cost of Aetna coverage varies depending on your plan type:
Employer-sponsored plans:Â often the most affordable option with shared premium costs.
Individual and family plans:Â vary by state and coverage level.
Medicare Advantage plans:Â available to seniors and eligible individuals with added vision benefits.
For most patients, there’s a small copay or coinsurance for medical eye visits once the deductible has been met. Routine eye exams may carry a separate copay if your Aetna plan includes EyeMed or other vision coverage.
What Does Aetna Cover for Eye Care?
Aetna provides coverage for a wide range of medical eye conditions when the visit is considered medically necessary.
Medical Eye Exams
Aetna covers eye exams related to the diagnosis and treatment of:
Glaucoma
Cataracts
Macular degeneration
Diabetic retinopathy
Dry eye disease
Eye infections or allergies
Eye pain, flashes, or floaters
Routine exams for vision prescriptions may not be covered under Aetna medical plans, but are often included in Aetna’s partnered vision plans through EyeMed.
Glasses and Contact Lenses
If you have Aetna Vision through EyeMed, you may receive:
A frame allowance (typically $130–$200)
Coverage for single vision, bifocal, or trifocal lenses
Discounts on lens upgrades such as anti-glare, UV protection, and Transitions
Without vision coverage, these costs are considered out-of-pocket under Aetna’s medical plan.
Are Medically Necessary Contact Lenses Covered by Aetna?
Yes. In cases where contact lenses are prescribed for medical necessity, such as keratoconus, severe dry eye, or corneal irregularities, Aetna medical insurance may cover the evaluation and materials once the deductible is met.
Our optometrists can determine if your condition qualifies and provide the required documentation to Aetna for approval.
Does Aetna Cover Diabetic Eye Exams?
Yes! Aetna medical insurance covers annual diabetic eye exams for members diagnosed with diabetes.
These exams are vital for detecting diabetic retinopathy, a leading cause of vision loss in adults. During your visit, our doctors evaluate your retina for bleeding or swelling and send a detailed report to your primary care physician or endocrinologist to coordinate care.
Does Aetna Cover Cataract Surgery?
Yes. Aetna covers medically necessary cataract surgery, including:
Removal of the cataract
Insertion of a standard intraocular lens (IOL)
If you choose to upgrade to a premium or multifocal IOL, that portion is typically considered an elective expense and is not covered.
Our team will guide you through the pre- and post-surgery process and coordinate your care with your cataract surgeon.
Does Aetna Cover LASIK or PRK?
No. Aetna does not cover LASIK or PRKÂ because these are considered elective procedures.
However, many Aetna plans offer discounts on LASIK through participating QualSight LASIK providers, typically between 15–25% off standard pricing.
If you’re interested in laser vision correction, we can help you explore available discounts and evaluate your candidacy.
Additional Aetna Benefits Patients Should Know
Preventive care focus:Â coverage for diabetic eye exams, glaucoma testing, and other medical evaluations.
Broad provider network:Â access to thousands of optometrists and ophthalmologists nationwide.
Integrated options:Â many Aetna plans include EyeMed vision benefits for glasses and contacts.
Technology-friendly:Â manage your claims and find doctors easily through the Aetna Health app.
Why Choose Reflect Vision Care for Your Aetna Eye Care
At Reflect Vision Care, we’re proud to accept Aetna medical insurance and help patients receive personalized, comprehensive eye care in Charlotte and Asheville.
Our doctors specialize in diagnosing and managing medical eye conditions while ensuring you understand your insurance benefits every step of the way. Whether you’re monitoring diabetes, managing dry eye, or checking for cataracts, we’ll provide the highest quality care tailored to your needs.
Schedule Your Aetna Eye Exam Today
Ready to use your Aetna medical insurance for your next eye exam? Our friendly team can verify your coverage and guide you through your visit with ease.
Schedule your eye exam at one of our convenient Reflect Vision Care locations:
📞 Call us or schedule online to book your appointment today!