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VisionCare Plan Overview
VisionCare Plan
offers you and your family a benefit that covers all routine eye care,
including eye exams and eyeglasses (lenses and frames) or contacts. The
plan features:
- In-network and out-of-network benefits
- Enhanced benefits in-network
- National panel of optometrists and ophthalmologists
- Exam Plus means if you prefer contacts you get your exam plus an allowance for contacts in place of lenses and frames
Frequently Asked Questions
How does the plan work with network doctors?
The plan is easy to use!
- Your VisionCare Plan ID card will be mailed to your home and your
Certificate of Benefits is included within this website. The Certificate
provides you with detailed information about the VisionCare Plan benefits.
- Select a VisionCare Plan network doctor (either through this website
or by calling our Customer Care Department at 800-865-3676). Call the network doctor you have selected
and make an appointment. Have your ID card ready so that you can give
the doctor's
office your policy number which is on the card. The doctor's office
will verify your eligibility and your plan benefits before your visit.
- Present your ID card at the time of your visit. After your exam, the
doctor will have you sign a VisionCare Plan form. You'll pay any
copayments at that time as well.
You have nothing more to do! The VisionCare Plan network doctor provides
you with services and bills the VisionCare Plan directly for the balance of your
bill.
Since the plan is designed to meet your eye care needs, optional upgrades
(like frames costing more than the plan limits, progressive lenses, or
contacts that are not medically necessary) will cost extra. However, since
all upgrades are on a wholesale basis, your cost will be lower than what you
would pay on your own.
What are the advantages of using a network provider?
Our national network of providers can provide you with one-stop shopping.
You get your eye exam and materials with nothing more than your copayment
(cosmetic options will include additional charges).
What if I want to see a provider not in your network?
If you prefer, you can visit an out-of-network doctor. If you do, you will pay
the doctor's regular charges and you will be reimbursed according
to the plan's non-network benefit schedule. Please refer to the Vision Out-of-Network Claim Form.
How can I get further questions answered?
You may contact the Customer Care Department with any questions or
concerns at 800-865-3676.
| Plan Frequencies |
Exam every 12 months
Lenses every 12 months
Frames every 24 months |
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Copayment for each member at the time of service |
Exam: $10
Lenses and/or frames: $15 |
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| Maximum
Allowances |
Network Doctor
(After copayments/Up to plan limits) |
Non-network
(Copayments apply) |
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Eye Exam |
Paid in full |
$35 |
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Lenses (per pair) |
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| Single |
Paid in full |
$20 |
| Bifocal |
Paid in full |
$40 |
| Trifocal |
Paid in full |
$60 |
| Lenticular |
Paid in full |
$100 |
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Contact Lenses |
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| Elective (exam & lenses)** |
Exam + $120 |
Exam + $120 |
| Medically necessary* |
Paid in full |
$150 |
| Frame |
$50 wholesale |
$50 retail |
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* Medically necessary (prior authorization required) is
defined a 1) following cataract surgery without intraocular lens; 2)
correction of extreme visual acuity problems not correctable with
glasses; 3) anisometropia greater than 5.00 diopters and
asthenopia or diplopia, with spectacles; 4) Keratoconus; or 5) monocular
aphakia and/or binocular aphakia where the doctor certifies
contact lenses are medically necessary for safety and
rehabilitation to a productive life.
**Benefits include (1) The cost of an annual vision exam, subject to the copayment; and (2) the cost of contact lenses, any fitting costs and follow-up visit up to the maximum of $120, not subject to the copayment. This is in lieu of all other benefits and not available when benefits for eyeglasses are received.
This schedule shows only a few of the covered
procedures. This schedule is intended for comparison purposes only. The
benefits of each plan will be determined by the contract. For a complete
listing of benefits and exclusions and limitations, please reference
your certificate of coverage.
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