Aetna Vision Discount Program

Better vision, better health

Vision discounts Plenty of locations You can visit many doctors in private practice, plus Clear, healthy vision can help you be more active and get national chains like LensCrafters®, Target Optical® and more done in a day. It can even boost your overall health. Pearle Vision®. Once you’re a member, you can use our provider search tool on your member website at Here’s a great way to take care of your eyes: extra Aetna.com to find a location. savings. And your covered family members can use the savings, too. Enjoy discounts on eyeglasses, Prescription and nonprescription savings contact lenses, LASIK surgery Your vision may be just fine. Or it may need a little help. and more. Either way, you can save with our vision discounts.

You get discounts on:

• Eye exams FSA You can use your flexible spending • Prescription eyewear account or health savings account HSA • LASIK laser eye surgery toward out-of-pocket expenses. • Non-disposable contact lenses • Designer frame options

You can even save on things that don’t need a prescription, like sunglasses, eyeglass chains, lens cases and cleaners.

THIS IS NOT INSURANCE. THIS GIVES YOU ACCESS TO DISCOUNTS ONLY. In Idaho, health benefits and health insurance plans are offered and/or underwritten by Aetna Health of Utah Inc. and Aetna Life Insurance Company (Aetna). For all other states, health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna HealthAssurance Pennsylvania Inc. and/or Aetna Life Insurance Company. In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Utah and Wyoming, by Aetna Health of Utah Inc. and Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.

Aetna.com 00.03.301.1 T (8/20) Discounts How to get started and savings Visit Aetna.com to search for providers, manage your benefits and view your ID card. Great rates on eye exams You can search for providers by name, You’ll get discounts on routine eye exams. And they location or even by the brand name of the aren’t just for clear vision. They help: frames you want. • Spot eye problems earlier • Find signs of serious conditions, like diabetes or high blood pressure, before they become a bigger problem See your world more clearly. Contact lenses — delivered to your door With choices and savings that come Need replacement lenses? If your prescription is up to date, you can get them mailed right to your home. with being an Aetna member. LASIK for less You get one low package price for laser eye surgery screening, surgery and follow-up care. And the first consultation is free — even if you decide not to have the surgery. No hassles and instant savings Just show your Aetna® ID card at any participating location for instant savings at the doctor’s office. You don’t need to get a referral or fill out a form to get your savings.

Visit Aetna.com/individuals-families/member-rights-resources/rights/disclosure-information.html to view or print your medical, dental or vision plan disclosures. Here, you can also find state requirements and information on the Women’s Health and Cancer Rights Act. Trademarks and logos displayed are the property of their respective owners. DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your health plan. You get access to discounts off the regular charge on products and services offered by third-party vendors and providers. Aetna makes no payment to the third parties — you are responsible for the full cost. Check any health plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts. Vendors and providers are not agents of Aetna and are solely responsible for the products and services they provide. Discount offers are not guaranteed and may be ended at any time. Aetna may get a fee when you buy these discounted products and services. Vision care providers are contracted through EyeMed Vision Care. LASIK surgery discounts are offered by the U.S. Laser Network and QualSight. Discounts are not available to New York policyholders.

Product or Service Discounted Fee

No discount applies. Eye exams covered by an Aetna insurance plan Review your medical plan for coverage details.

Eye Exams when not covered by an Aetna insuranceplan Routine eye exam $49.00 Standard Contact Lens Evaluation and Fitting $40.00 (plus $49 exam fee) Routine eye exam required to receive discount Premium Contact Lens Evaluation and Fitting (Including, but not limited to, Toric, Bifocal, GasPermeable) * 10% off standardfee (plus $49 exam fee) Routine eye exam required to receive discount

Lenses per Pair (uncoated plastic)** Single Vision $40.00 Bifocal $60.00 Trifocal $80.00

Standard Progressive (no-line bifocal) $125.00

Eyeglass Frames (prescription only)** 35% off retail prices

Lens Options per Pairs (add to lens price above) Polycarbonate (includes UV coating and scratch- $40.00 resistant coating)

Scratch-resistant coating $15.00 Ultraviolet (UV) coating $15.00 Solid or gradient tint $15.00 Standard anti-reflective coating $45.00 Glass 20% off retail Contact Lenses 15% discount off retail on conventional lenses

15% off standard prices or 5% off promotional prices for LASIK services obtained through the U.S. Laser Network. Lasik Procedure Members must call before scheduling an appointment.

Additional Vision-Related Items 20% discount off retail prices To find vision discount provider locations, log into the member website at aetna.com and select discounts. Or call 1-800-793-8616 and reference plan # 46543. Aetna® Vital Savings members reference plan # 47196.

10.03.332.1 (9/19) aetna.com *Specialty (i.e. Toric, Multifocal, Rigid Gas Permeable) Note: Standard and Specialty Fit & Follow-up are added to the Comprehensive Eye Exam

**No complete pair purchase required

THIS IS NOT INSURANCE

***Since LASIK or PRK vision correction is an elective procedure, performed by specially trained providers, this discount may not always be available from a provider in your immediate location. For a location near you and the discount authorization, please call 1-800-422-6600.

Member will receive a 20% discount on those items purchased at participating providers that are not specifically covered by this Discount design. The 20% discount may not be combined with any other discounts or promotional offers, and the discount does not apply to EyeMed Provider's professional services, or contact lenses. Retail prices may vary by location.

Limitations/ Exclusions • Orthoptic or vision training, subnormal vision aids, and any associated supplemental testing • Medical and/or surgical treatment of the eye, eyes, or supporting structures • Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan • Services provided as a result of any Worker's Compensation law • Discount may not be available on certain brand name Vision Materials (i.e. eyeglass frames) in which the manufacturer imposes a no-discount practice

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).

This material contains only a partial, general description and does not constitute a contract. Health information programs provide general health information and are not substitutes for diagnosis or treatment by a physician or other health care professional. Discount offers are available to people who have health benefits plans that are issued by, administered by, or serviced by Aetna or our affiliates.

Discount offers provide access to discounted services and are not part of an insured plan or policy. Discount offers are rate-access offers and may be in addition to any plan benefits. Check any insurance benefits you have before using these discount offers, as those benefits may result in lower costs to you than using these discounts. Discount offers are not guaranteed and may be discontinued at any time. Aetna makes no payment to the discount vendor. The member is responsible for the full cost of the discounted services.

Aetna does not endorse any vendor, product or service associated with this discount offer program. Vendors are independent of Aetna, not agents or employees thereof. Programs, products and services may not be available at all times. Certain offers may not be available in some states. Products may be subject to a warranty from the manufacturer. Aetna makes no representations or warranties, and disclaims all product warranties. The discount offers have no liability for providing or guaranteeing service and assumes no liability for the quality of service rendered. Aetna may receive a percentage of the fee paid to a discount vendor. While this material is believed to be accurate as of the production date, it is subject to change.

LASIK surgery discounts are offered by the U.S. Laser Network. Providers are independent surgeons and are not agents or representatives of EyeMed, Aetna Health Inc. or their affiliates. Eye Med Services and Compensation Schedule, 1/01/20. Certain brands impose a no-discountpolicy

For Texas Members: Discount programs are not insurance and program features are not guaranteed under the plan contract and may be discontinued at any time. Discount programs are in addition to any plan benefits and may require a separate charge to access such programs. Discounts offered hereunder are not insurance.

10.03.332.1 (9/19) aetna.com For California members, vision discounts are not offered under the member’s benefit plan contract. Members with covered benefits should exhaust those benefits prior to using these discounts. These services and products are provided by organizations other than Aetna. The discounts are reductions from the provider’s usual fee (retail price) for the service. Actual costs and savings vary by geographic area. If you have questions about the Aetna vision discounts, please call 1-800-756-7039. For HMO members, any complaints about these discount programs may be submitted using the process described in your Evidence of Coverage. For more information on these programs, check with your employer or call the Member Services number on your IDcard.

Policy form numbers issued in Oklahoma include: GR-96402-02 04-09.

10.03.332.1 (9/19) aetna.com Plan #: 46543 Seeing Expires: 12/31/21

Aetna VisionSM discounts things ... Membership card Member signature

To find a location, go to aetna.com, then “Find a Doctor.” Under “Provider Types,” click “Vision routine eyewear and exam.” Clearly see big savings with Or call 1-800-793-8616. Aetna VisionSM discounts Plan #: 46543 Expires: 12/31/21 Savings right in your pocket Aetna VisionSM discounts Sign one card and share the other with a family member. Membership card Then, when you shop at a participating location for eyewear or other vision services — show the card to get your discount. Member signature

To find a location, go to aetna.com, then “Find a Doctor.” Under “Provider Types,” click “Vision routine eyewear and exam.” Or call 1-800-793-8616.

10.11.304.1A (1/20) TTY: 711 Aetna Vision discounts Para acceder a los servicios de idiomas sin costo, llame Exam and Eyewear: 1-800-793-8616 al número figura en su tarjeta de identificación. (Spanish) LASIK Customer Service: 1-800-422-6600 Contacts Direct: 1-844-553-6737 如欲使用免費語言服務，請致電您 ID 卡上的電話號碼 (Chinese) Aetna Vision discounts is a discount-only program. Providers are solely responsible for the products and services provided under the program. Aetna does not endorse any vendor, product or service associated with this program. Discounts Aetna is the brand name used for products and services offered under this program are not insurance. No eligibility provided by one or more of the Aetna group of subsidiary verification required; process sale under 46543. companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions Aetna Vision discounts and limitations. Information is believed to be accurate as of Exam and Eyewear: 1-800-793-8616 the production date; however, it is subject to change. For LASIK Customer Service: 1-800-422-6600 more information about Aetna plans, refer to aetna.com. Contacts Direct: 1-844-553-6737

Aetna Vision discounts is a discount-only program. Providers are solely responsible for the products and services provided under the program. Aetna does not endorse any vendor, product or service associated with this program. Discounts offered under this program are not insurance. No eligibility verification required; process sale under 46543. Aetna.com