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HumanaVision Overview
HumanaVision
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
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| The most popular retail optical locations, including LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JCPenney Optical
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| Exam Plus means if you prefer contacts you get your exam plus an allowance for contacts in place of lenses and frames
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Frequently Asked Questions
How does the plan work with network doctors?
The plan is easy to use!
- Your HumanaVision 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 HumanaVision benefits.
- Select a HumanaVision network doctor (either
through this website or by calling our Customer Care Department at
866-537-0229). 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. You'll pay any
copayments at that time as well.
You have nothing more to do! The HumanaVision network doctor provides
you with services and bills HumanaVision 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 consists of both private practitioners and the most recognized retail optical outlets. This unique plan offers the accessibility of the nation's premier locations with the cost control features that reduces the total costs of care.
You get your eye exam and materials with nothing more than your copayment
(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 HumanaVision 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 866-537-0229.
| 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 |
* Medically necessary (prior authorization required) is the following situations:
1. Following cataract surgery;
2. When visual acuity cannot be corrected to 20/70 in the better eye except by their use;
3. Anisometropia of greater than 3.50 diopters and aesthenopia or diplopia, with spectacles;
4. Keratoconus diagnosis where contact lenses are treatment of choice;
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.
***The frame allowance is based on a wholesale amount. If the actual wholesale cost exceeds the wholesale frame allowance, you will be required to pay twice the wholesale difference.
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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