Vision Coverage
NEW! OptumHealth now provides two plans for employees to choose from: the Select Plan and the Select Plus Plan.
NEW! For 2010, the vision plan has changed from a 2 tier to a 4 tier structure. Employee only, Employee + Spouse, Employee + Children, or Employee + Family coverage is offered. Your cost depends on the option and coverage level you select.
Both Vision Plans, provided through OptumHealth, features:
• covered exams and materials;
• statewide access to a network of panel providers;
• no claims to file for "in-network" benefits; and
• benefits for "out-of-network" providers.
Important to Remember
- Certain standard contact lenses, including daily wear, and up to 4 boxes of standard single vision disposable contacts are covered in full for your co-payments. Under the Select Plan, if you purchase contacts that are not among OptumHealth's "covered in full" selection, you will receive an annual $105 allowance toward the purchase of contact lenses, and professional fees (i.e., fit and follow-up).
- Please note: Under the Select Plus Plan, the annual allowance is $125.
- Please note: To receive the full $105 allowance under the Select Plan, you must receive your exam, fitting and evaluation at a single visit to the same network provider (at Wal-Mart, $70 of the $105 allowance is allocated to materials and $35 to professional fees). The allowance will only apply to one purchase per plan year. You must submit all receipts at the same time. Any balance remaining and not used during the plan year when the purchase occurred will be forfeited.
- Please note: To receive the full $125 allowance under the Select Plus Plan, you must receive your exam, fitting and evaluation at a single visit to the same network provider (at Wal-Mart, $70 of the $105 allowance is allocated to materials and $55 to professional fees). The allowance will only apply to one purchase per plan year. You must submit all receipts at the same time. Any balance remaining and not used during the plan year when the purchase occurred will be forfeited.
- The OptumHealth Vision Select Plan covers standard single vision and standard lined multi focal lenses for glasses. Cosmetic lens options such as tinting, UV coating, progressive lenses, etc., are not covered, but are provided to OptumHealth's members at a savings below normal retail charges.
- Please note: Under the OptumHealth Vision Select Plus Plan cosmetic lens options is offered for Tints, UV, Polycarbonate and Basic Progressive lenses.
- Always verify coverage by identifying yourself as an OptumHealth member under the State of Georgia plan when making your appointment. Give the provider the employee's social security number, patient's name and the patient's date of birth. Benefits are provided every 12 months for exams, lenses and/or contacts and every 24 months for frames measured from the last date of service.
Exclusions
The Vision Plan does not cover:
- replacement of lost lenses or frames
- medical or surgical treatment of eye conditions
- amounts above the schedule of benefits or allowances
- services or materials not included as eligible expenses by the Vision Plan
- cosmetic extras such as no line multifocal lenses, tints, UV coatings etc. (Select Plan Only)
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