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| Description of Benefits |
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| Benefit |
Frequency |
Member Pays |
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| Eye Examination |
Every 12 Months |
100% Covered |
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| Lenses |
|
|
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| Single Vision |
Every 12 Months |
100% Covered
up to plan allowance |
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| Bifocal |
Every 12 Months |
100% Covered
up to plan allowance |
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| Trifocal |
Every 12 Months |
100% Covered
up to plan allowance |
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| Lenticular |
Every 12 Months |
100% Covered |
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Tint #1
Any color, plastic lenses only |
Every 12 Months |
100% Covered |
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Frames*
* The employees will pay the additional charges if they select frames costing more than the plan allows |
Every 24 Months |
100% Covered
up to plan allowance |
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| Contact Lenses |
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| Cosmetic Contact Lenses are available each 12 months in addition to your basic benefit (see schedule of extras); or, if desired in lieu of all other services, $100 applies to the Doctor's Customary Package Fee.
Option1: Receive basic services (eye examination, refraction, eyeglass lenses and frame) and receive the co-payment (if any) for eye examination and any extras for the eye glasses. Members are eligible for contact lens services under the Schedule of Extras.
OR
If the member wishes Contact Lenses in lieu of Glasses
Option 2: “Contact Lenses in lieu of Basic Benefit”: After the member pays the Co-payment (if any), they receive a $100.00 credit towards the doctors Usual and Customary Package for Exam (refraction), Fitting, and Contact Lenses.
Example: (after co-payment)
| Exam = |
$75.00 + |
| Fitting = |
$75.00 + |
| Contact Lenses = |
$150.00 |
| Total Package = |
$300.00 – |
| C.L. Benefit = |
$100.00 |
| Member Pays = |
$200.00 |
|
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| Medically Necessary Contact Lenses are available each 24 months as needed. This is a $250 benefit which includes: a special contact lens examination, fitting, and Medically Necessary Contact Lenses. |
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| LASIK Benefit |
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Vision Plan of America is now providing members ACCESS TO a Laser Vision Correction preferred pricing plan! The Qualsight Preferred Pricing Program offers an enhancement to your VPA plan including:
- Savings – you can now save 40-55% off the overall national average charge for LASIK!
- Experienced Physicians – national access to credentialed, Board Certified Ophthalmologists who use state-of-the-art, FDA approved LASIK equipment
- Convenience – our Care Managers provide a thorough prescreening process along with education about LASIK technologies, cost and benefits
- Financing – flexible financing available to qualified candidates.
To Access Preferred Pricing Call: 877 507 4448
Hours: 7 am - 9 pm (CST) Weekdays; 10 - 5 pm Saturdays
www.Qualsight.us
The Qualight program is not an insured benefit. Vision Plan of America makes access to the Qualsight Program available to its members for preferred pricing FOR LASIK surgery. Vision Plan of America makes no specific recommendation for or against the Plan. All representations are those Qualsight. |
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| Many additional services are available at reduced fees on our schedule of extras. |
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