Vision Benefits

• UnitedHealthcare Eye Exams
• EyeMed Vision Care

UnitedHealthcare – Annual Eye Examinations

Annual eye exams are covered under the UnitedHealthcare medical plan for participating employees and their eligible dependents as follows:

UnitedHealthcare PPO Plan

If you participate in the PPO300 or PPO600 plan, you may select any eye doctor within the UnitedHealthcare PPO network. A routine annual eye exam, including refraction to detect vision impairment, received in a provider's office is covered as a preventive care service under the medical plan as described below:

When visiting an in-network Choice Plus provider, preventive care services are covered at 100 percent of eligible expenses without deductible, coinsurance or office visit copay for both PPO300 and PPO600.

Preventive care services provided by out-of-network providers are paid at 60 percent for both PPO300 and PPO600 after the deductible is satisfied.

Benefits are not available under the medical plan for charges connected to the purchase or fitting of eyeglasses or contact lenses.

UnitedHealthcare EPO Plan

Employees and dependents enrolled in the EPO plan must use a UnitedHealthcare eye doctor within the EPO Choice network for their routine annual eye exam to be covered under the plan. An annual routine eye examination, including refraction to detect vision impairment, received from a Choice network health care provider in the provider's office is covered as a preventive care service at 100 percent of eligible expenses without coinsurance or office visit copay.

Benefits are not available under the medical plan for charges connected to the purchase or fitting of eyeglasses or contact lenses.

EyeMed Vision Care

(If you are in a group that is paid weekly, please contact your Group/Region HR or payroll department for weekly vision premium rates.)

To locate a provider near you, call EyeMed at 800-841-1220 to speak with an EyeMed customer service representative or visit www.eyemedvisioncare.com and choose the Select Network in the drop down box under “Locate a Provider.”

If you enroll for vision benefits, you will receive an ID card from EyeMed Vision Care. Always carry your ID card and present it to the vision care provider when receiving care.

Also, once you have enrolled with EyeMed, you will want to register on the secured site at www.eyemedvisioncare.com to view your personal vision care benefit information, view claims status, print additional ID cards online and sign up to receive EOBs by e-mail if you choose.

EyeMed Vision Care's network of providers includes private practicing optometrists, ophthalmologists, opticians, and many retail chains, including the nation's leading optical retailer, LensCrafters®. A description of your vision care benefit is available below:

Vision Care Services In-Network Member Cost Out-of-Network Reimbursement Exam with Dilation as Necessary $10 Copay Up to $35 Frames: $120 Allowance; 80% of remaining charge Up to $45 Standard Plastic Lenses: Single Vision $10 Copay Up to $25 Bifocal $10 Copay Up to $40 Trifocal $10 Copay Up to $55 Lenticular $10 Copay Up to $55 Lens Options (paid by the member and added to the base price of the lens): Tint (solid and gradient) $15 N/A UV Coating $15 N/A Standard Scratch-Resistance $15 N/A Standard Polycarbonate <age 19 $0 Up to $5 Standard Polycarbonate >age 19 $40 N/A Standard Anti-Reflective $45 N/A Other Add-Ons and Services 80% of retail price N/A Contact Lenses (includes contact lens materials only; in lieu of Standard Plastic Lenses): Conventional $115 Allowance; then 85% of remaining charge Up to $100 Disposables $115 Allowance; Up to $100 Medically Necessary $0 Up to $200 LASIK and PRK Vision Correction Procedures 85% of retail; OR 95% of promotional pricing N/A Frequency: Exams Once every calendar year Frames <age 19 Once every calendar year Frame >age 19 Once every two calendar years One of the following: Standard Plastic Lenses; OR Contact Lenses Once every calendar year   Note: The UnitedHealthcare, Delta Dental and Express Scripts benefits described on this site DO NOT APPLY to Hawaii employees. Go here for Hawaii Health and Wellness.

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LASIK and PRK Benefit
EyeMed is pleased to provide all EyeMed Vision Care members with a laser vision correction benefit. EyeMed and LCA-Vision have arranged to provide this benefit to all EyeMed Vision Care members through the U.S. Laser Network. Members are entitled to a 15% discount on the usual and customary fees for LASIK and PRK procedures, or a 5% discount on any promotional pricing, whichever is the greater benefit. One easy phone call to 1-877-5LASER6 begins the process of using your benefit. No claim forms are needed, making it a hassle free process for members.

Continued Eyewear Savings
Your EyeMed benefit also provides for continued savings through our secondary purchase plan. After your initial benefits have been utilized, you are able to receive ongoing discounts on additional eyewear purchases at EyeMed provider locations, which result in discounts up to 40% off the retail price of eyewear and accessories. See your EyeMed provider for details.

Contact Lens By Mail Program
You may order replacement contact lenses for competitive prices via the internet, and have the contacts mailed directly to your home. The service is for replacement contact lenses only, and your core benefit allowance or discount will not apply to the service. Your initial pair of contact lenses must still be purchased from your eye care provider to ensure proper fit and follow-up care. Simply visit www.eyemedvisioncare.com for details and a link to the order site.

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