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Vision Insurance
The United Healthcare Vision plan provides professional vision care and high quality lenses and frames through a broad network of
optical Specialists. UHC’s vision network includes access to many Providers and locations including independent ophthalmologists
and optometrists, as well as COSTCO, Wal-Mart, Sam’s Club and several other retail stores. You will receive richer benefits if you
utilize a network Provider. If you utilize a non-network Provider, you will be responsible to pay all charges at the time of your
appointment and will be required to file an itemized claim with United Healthcare.

VSP Vision
Plan Features PPO Plan

Network Non-Network
Examination Copay $10 Copay Up to $40 Benefit
Materials Copay $10 Copay See below
Lenses
- Single Vision 100% Up to $40 Benefit
- Bifocal 100% Up to $60 Benefit
- Trifocal 100% Up to $80 Benefit

Frames $130 Benefit
Up to $45 Benefit
- Discount off amount over allowance 30% Benefit
Contact Lenses
(in lieu of frames/lenses)
- Cosmetic / Elective $125 Benefit Up to $125 Benefit
- Necessary Contact Lenses 100% Benefit Up to $210 Benefit
Frequency
- Examination Once Per Plan Year (12 months)
- Lenses Once Per Plan Year (12 months)
- Frames Once Every Other Plan Year (24 months)
- Contact Lenses Once Per Plan Year (12 months)

Finding a Vision Provider
Go to www.myuhcvision.com or call (800) 638-3120 to find a provider near you.

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