BENEFITS AT A GLANCE
Employees can elect Vision Coverage on themselves, spouse and/or children. The plan is setup with a copay for exams/materials if using an In-Network Provider. Out of Network provider benefits are reimbursements up to set levels.
ENHANCEMENTS ADDED
Children’s Eye Care Program added for Children under 13 with a change of .5 diopter or more receive a 2nd exam and replacement frames/lens benefit with the same copays.
Additional Maternity Benefit where expecting and breastfeeding women will receive a 2nd exam and replacement frames/lens benefit with the same copays – a prescription change will be necessary for the second benefit.
GlassesUSA is now in-network with virtual ‘try on’ frames. The site includes scratch guard coating, anti-reflective and ultraviolet protection on all of the lenses for glasses, at no additional cost.
Warby Parker is another provider now offering contact lenses through their store/site.
LensCrafters & 1-800 Contacts is now in-network
QualSight offers members set prices of up to 35% off the national average price of Lasik
SUMMARY OF BENEFITS
View the Summary of Benefits with Printable ID Card
| Cost | Service |
| $0 Copay | Exam |
| $10 Copay | Materials |
| $150 Allowance | Frames |
| $150/6 boxes | Contacts |
| Material Copay Includes: | Polycarbonate Lenses single/multifocalStandard Progressive LensesScratch Resistant Coating |
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PLAN HIGHLIGHTS
Exams and Lenses are available every 12 months
Frames are available every 24 months
Contact lenses are provided in lieu of spectacle lenses and frames.
Have Questions? See the FAQ Member Flyer
ADDITIONAL VISION BENEFIT:
If you have SHBP as your medical plan, one eye examination (per person) can be received every 24 months from an In-network healthcare provider’s office at no cost.
HOW TO USE YOUR VISION BENEFITS
RATES
| Coverage | July 2019 – June 2022 | July 2022 – June 2024 |
| Employee Only | $7.71 | $7.90 |
| Employee & Spouse | $14.84 | $15.21 |
| Employee & Child(ren)* | $15.54 | $15.93 |
| Family | $23.94 | $24.54 |
* Eligible Dependents include children to age 26
Coverage includes a second eye exam each plan year for members up to age 13 — at no additional premium cost, standard copays apply.
A new pair of glasses (frames and lenses) for a covered child up to age 13 at no additional cost if the vision prescription changes .5 diopter or greater in a plan year. (A diopter is the unit used to measure the optical power of the lens an eye requires.) Standard copays apply.
Polycarbonate lenses for dependent children ti age 19 are available at no additional cost.
PROVIDERS
Receiving your Vision Benefit is as easy as visiting your UnitedHealthcare/Spectera Vision Providers.
To locate providers, call 1-800-638-3120 or use the Vision Provider Locater at www.myuhcvision.com
CONTACT LENS BENEFIT
Contact lens benefit covers in-full (after applicable copay) the fitting/evaluation fees, contacts (disposable contacts/up to 6 boxes, depending on prescription), and up to 2 follow up visits. A $150 allowance is applied toward the fitting/evaluation fees and purchase of contact lenses outside of UHC’s covered-in-full contacts (materials copay does not apply). Toric, gas permeable, and bifocal contacts are all examples of contacts that are outside of our covered-in-full selection.
IN AND OUT OF NETWORK PAYMENTS
Network Benefits – Exam and materials copays and patient options are paid to the network provider by the plan participant.
Out-of-Network Benefits – The plan participant pays full fee to the provider and UHC reimburses the participant for services rendered up to a maximum allowance. There are no copays or deductibles.
