Eligibility |
The Vision Care Benefit is available to all active and retired members and their eligible dependents. |
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Basic Benefit Description |
This benefit helps pay for annual vision examinations and for glasses and contact lenses, subject to the rules of the Plan. The Plan uses a network of opticians, optometrists, and ophthalmologists called Vision Service Plan (VSP) to provide these benefits in an efficient and cost-effective way. Reduced benefits are available when you use a provider outside the VSP network. How often you can use the benefit and your copayment are shown in the benefit schedule below. |
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Benefit Schedule when using a VSP Provider | |
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Frequency |
Your Copayment |
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Eye Examinations |
once every 12 months |
$10 |
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Lenses |
once every 12 months |
$10 (for both lenses and frames) |
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Frames |
once every 24 months |
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Contacts (can be chosen instead of lenses and frames) |
12 months |
$10 |
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Benefit Schedule when using non-VSP Provider | |
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Frequency |
Plan Pays (you pay entire remainder) |
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Eye Exam |
once every 12 months |
up to $40 |
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Lenses |
once every 12 months |
up to $40/single vision
up to $60/bifocal
up to $80/trifocal
up to $125/lenticular
contact lenses (when medically necessary) - $210 |
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Frames |
Effective 8/1/2008: $200 every 24 months |
up to $0
contact lenses (elective) - $105 |
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Group Numbers |
Active and Retiree: #12140808. |
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Contact Info |
Phone Number: 1-800-877-7195 |
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