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BENEFITS

Glossary of Terms

 Deductible: The amount of out‐of‐pocket expenses that you must pay for before any expenses are payable by the plan.
 Copay: The flat dollar amount a covered individual is required to pay for certain services (could be before or a er mee ng
any applicable deduc ble).
 Out-of-Pocket Maximum: The annual maximum amount of money you will pay in addi on to copays and deduc bles.
 In-Network: Providers or facili es who have agreed to discounted fees with insurance carriers to par cipate within their
provider networks.
 Non-Network: A provider with whom an insurance carrier does not have a contract to provide healthcare services. A
member may pay higher copays, coinsurance and/or deduc bles to see a non‐network provider or have no coverage at all.

Educational Video
Benefits terminology can get confusing. Click here to watch a quick video to learn the basics of how our
medical plans work.

Deduc bles, Copays, Coinsurance, and Out‐of‐Pocket Maximums
h p://video.burnhambenefits.com/terms/

Vision Insurance

Aetna | PPO Vision Plan
The Aetna vision plan provides professional vision care and high quality lenses and frames through a broad network of optical
specialists. You will receive richer benefits if you utilize a network provider. If you utilize a non‐network provider, you will be
responsible to pay all charges at the time of your appointment and will be required to file an itemized claim with Aetna.

Aetna Note
Plan Name Vision Preferred
Our Vision plan
through Aetna
Network Name In‐Network Non‐Network
vision preferred
Vision Benefits network, your
network includes
Examina on (Every 12 Months) $10 Copay $25 Reimbursement access to
independent
Lenses (Every 12 Months) ophthalmologists
‐ Single Vision $25 Copay $10 Reimbursement and optometrists, as
‐ Bifocal $25 Copay $25 Reimbursement well as
‐ Trifocal $25 Copay $55 Reimbursement LensCra ers®,
‐ Progressive $90 Copay $25 Reimbursement
Target Op cal, Sears
Op cal, and Pearle
Frames (Every 24 Months) $130 Benefit Vision retail stores.
$90 Reimbursement
20% Discount Off Balance
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
‐ Cosme c / Elec ve $130 Benefit $90 Reimbursement
‐ Medically Necessary No Copay $200 Reimbursement
Laser Vision Correc on 15% off retail or 5% off promo onal price

Finding a Vision Provider
Go to www.aetnavision.com. Click on “Find A Provider”. Begin your search by entering the zip code. To print
your provider directory, click “Print All” towards the bo om of the page.

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