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| Vision Care, Inc., through our parent company CompBenefits Corporation, is pleased to offer the Optix Vision Plan. This plan provides access to independent eyecare professionals who are committed to providing quality vision care. You decide whether to obtain services from an optometrist or ophthalmologist from the list of providers on the following pages (panel plan) or you may prefer a non-participating eye doctor and be reimbursed according to the non-panel benefit schedule. The panel has a one-time copayment for frames and/or lenses. The chart below indicates the services covered by the plan. | ||
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| Covered Services* | Panel | Non-Panel |
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| One time Co-payment (Applies to frames and/or lenses) |
$10 | N/A |
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| Vision Exam (once every plan year) | Paid in full | Up to $40 |
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| Single Lenses (once every plan year) | Paid in full** | Up to $40 |
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| Bifocal Lenses (once every plan year) | Paid in full** | Up to $50 |
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| Trifocal Lenses (once every plan year) | Paid in full** | Up to $60 |
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| Frames | ||
| From Select Group | Paid in full | N/A |
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| Non-Select Group | up to $25 wholesale allowance | Up to $40 |
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| Frequency | once a year | every 2 years |
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| Second complete pair of glasses | 20% provider discount**** | N/A |
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| Contact Lenses | ||
| Elected by Insured | Paid in Full*** or up to $100 allowance |
up to $100 |
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| Medically Necessary | Paid in Full*** or up to $175 allowance |
up to $175 |
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| Contact Lens Fitting Fee | Paid in Full*** | N/A |
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| Mail Order Contact Replacement | 20% provider discount | N/A |
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| LASIK surgery | $3,600 both eyes | N/A |
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| Optional Services at Additional Costs (for panel plan) |
You Pay | |
| Solid Tint | $12 | |
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| Gradient Tint | $12 | |
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| Ultra Violet Filter | $20 | |
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| Scratch Resistance Coating | $20 | |
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| Anti-Reflection Coating | $60 | |
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| Glass PGX | You Pay | |
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| Single Vision | $35 | |
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| Multifocal | $45 | |
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| * During any plan year, the member may elect either the
frame and/or lenses covered service or the contact lenses allowance, but
not both.
**Single vision, bifocal (flat to 25) or trifocal (7 X 25) are paid in full. At the providers option, lenses can be made at either the doctor's office lab, or sent to a participating lab. *** Limited to a select group of daily wear contacts (CIBA Soft, Wesley Jessen D2T4, and Optima 35) and does not include the fitting fee. The allowance applies to non-select group contact lenses. ****Available for 12 months following the covered eye exam from the same doctor who performed the initial exam. |
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To submit comments or questions, please visit our Contact Center. © Copyright CompBenefits 2004.
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