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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
Frequently Asked Questions
How does the plan work with network doctors?
The plan is easy to use!
- Obtain a VisionPass/Benefit Form by calling our Member Services
Department at 800-865-3676 M-F 8am-6pm or by faxing a
request to us at 800-421-0100. You may also request a VisionPass/Benefit Form through this website at MyCompBenefits. With
MyCompBenefits, you can obtain the VisionPass/Benefit
Form through email, fax, postal mail, or print a copy from the website.
- Once you have obtained a VisionPass/Benefit Form (valid for 60 days),
select a VisionCare Plan network doctor (either through this website or by
calling our Member Services Department at 800-865-3676 M-F 8am-6pm. Call the network doctor you have selected and make an
appointment.
- Present your VisionPass/Benefit Form to the doctor during your visit.
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 CompBenefits 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 a non-network doctor. If you do, you will pay
the doctor's regular charges and CompBenefits will reimburse you according
to the plan's non-network benefit schedule.
How can I get further questions answered?
You may contact the Member Services Department with any questions or
concerns at 1-800-865-3676, Monday through Friday 8am to 6pm.
| Plan Frequencies |
Exam every 12 months
Lenses every 12 months
Frames every 12 months |
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| Maximum
Allowances |
Network Doctor
(After copayments/Up to plan limits) |
Non-network
(Copayments apply) |
|
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| |
|
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Eye Exam |
Paid in full |
$35 |
|
Lenses (per pair) |
|
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| Single |
Paid in full |
$25 |
| Bifocal |
Paid in full |
$40 |
| Trifocal |
Paid in full |
$60 |
| Lenticular |
Paid in full |
$100 |
Polycarbonate lenses
|
Paid in full |
N/A |
Transition lenses
|
Paid in full |
N/A |
Progressive lenses 1, 2, and 3
|
Paid in full |
N/A |
| Contact Lenses |
| |
| Elective (exam & lenses) |
Exam +
$
105** |
Exam +
$
105** |
| Medically necessary* |
Paid in full |
$210 |
| Frame |
$45 wholesale |
$45 retail |
| Lasik*** |
Members will receive a discount if
services are rendered by a TLC Network provider and they will pay no
more than $1800/eye. |
No benefit |
| |
Discount Only |
No Benefit |
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* Medically necessary (prior authorization required) is defined as 1)
following cataract surgery w/o 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 $105, not subject to the copayment. This benefit is in lieu of all other benefits and not available when benefits for eyeglasses are received.
***Plan members must first contact CompBenefits for a list of providers
and to receive a Refractive Care ID card.
This schedule shows only a few of the covered procedures. Please see your
Benefit Administrator for a complete schedule. 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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