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Vision
Because symptoms of health conditions often don’t appear until
damage has already occurred, eye exams are a great way to keep tabs
on what’s happening in your body. Your eyes can tell your doctor a
lot about your overall health. Our vision insurance coverage, offered
in partnership with UnitedHealthcare is designed to meet a variety of
needs. Please note, ID cards are not issued for vision beneits. If you
are enrolled in vision coverage, providers will verify coverage using
your Social Security number.
Find an In-Network Provider
Remember to visit in-network providers to receive the deepest level of
discount on your services. To ind a participating in-network provider
in your area go to www.myuhc.com for those with UHC medical
coverage, www.myuhcvision.com for vision only members, or call
877.426.9300.
In-Network Out-of-Network
Copay
Exam $20 copay Up to $40
Materials $20 copay N/A
Lenses
Single $20 copay Up to $40
Bifocal $20 copay Up to $60
Trifocal $20 copay Up to $80
Lenticular $20 copay Up to $80
Frames
$20 copay; up to $130 Up to $45
allowance, 30% off of
balance over allowance at
participating providers
Contacts
Elective $20 copay; up to $130 Up to $130
allowance Vision Plan
Medically necessary $20 copay; covered in full Up to $210 Bi-
Frequency Weekly Weekly Monthly
Exam 12 months Employee $1.12 $2.24 $4.86
Lenses 12 months
Contacts (in lieu of 12 months Employee $2.13 $4.26 $9.22
glasses) and spouse
Frames 24 months Employee $2.50 $4.99 $10.82
and
child(ren)
This is a high level summary of your beneit coverage. Full coverage details are available in Family
your summary plan description (SPD). In the event there is a discrepancy between what is $3.51 $7.02 $15.22
relected in this guide and what is communicated in your SPD, the terms of your SPD will
prevail.
11
Because symptoms of health conditions often don’t appear until
damage has already occurred, eye exams are a great way to keep tabs
on what’s happening in your body. Your eyes can tell your doctor a
lot about your overall health. Our vision insurance coverage, offered
in partnership with UnitedHealthcare is designed to meet a variety of
needs. Please note, ID cards are not issued for vision beneits. If you
are enrolled in vision coverage, providers will verify coverage using
your Social Security number.
Find an In-Network Provider
Remember to visit in-network providers to receive the deepest level of
discount on your services. To ind a participating in-network provider
in your area go to www.myuhc.com for those with UHC medical
coverage, www.myuhcvision.com for vision only members, or call
877.426.9300.
In-Network Out-of-Network
Copay
Exam $20 copay Up to $40
Materials $20 copay N/A
Lenses
Single $20 copay Up to $40
Bifocal $20 copay Up to $60
Trifocal $20 copay Up to $80
Lenticular $20 copay Up to $80
Frames
$20 copay; up to $130 Up to $45
allowance, 30% off of
balance over allowance at
participating providers
Contacts
Elective $20 copay; up to $130 Up to $130
allowance Vision Plan
Medically necessary $20 copay; covered in full Up to $210 Bi-
Frequency Weekly Weekly Monthly
Exam 12 months Employee $1.12 $2.24 $4.86
Lenses 12 months
Contacts (in lieu of 12 months Employee $2.13 $4.26 $9.22
glasses) and spouse
Frames 24 months Employee $2.50 $4.99 $10.82
and
child(ren)
This is a high level summary of your beneit coverage. Full coverage details are available in Family
your summary plan description (SPD). In the event there is a discrepancy between what is $3.51 $7.02 $15.22
relected in this guide and what is communicated in your SPD, the terms of your SPD will
prevail.
11
