Officers - Vision

All Officers and their covered dependents enrolled in any of the University’s medical plans are covered by a Basic Vision benefit through UnitedHealthcare (UHC). This embedded plan provides coverage for eye exams, corrective lenses, frames and contact lenses.

Officers also can elect to purchase Optional UHC Vision coverage for themselves and covered dependents that is in place of the basic vision benefit in their medical plan. If an Officers does not purchase Optional Vision, then they will keep the Basic Vision plan.

To search for a vision provider, log in to www.myuhcvision.com and search by name, specialty and location.

Basic Vision Coverage

High Deductible Health Plan (HDHP): Adults: One exam every 12 months; plan pays 90% after deductible, no copay.

Children:* One exam every 12 months; plan pays 90% after deductible, no copay.
Choice Plus Plans: Adults: One exam every 12 months with a $10 copay.

Children:* One exam every 12 months with a $10 copay.

^{* Child is defined as a member less than age 19.}

Benefits apply both In-Network and Out-of-Network

Note: Provider may require payment in full at the time of service. The patient then submits a claim to UHC for reimbursement.

High Deductible Health Plan (HDHP)*: Adults: $100 allowance every 12 months (combined for lenses and frames or contact lenses).

Children:** One pair of eyeglasses (lenses and frames) OR one pair of contact lenses from Essential Health Benefits (EHB) Formulary List (or a 12-month supply) every 12 months with a $75 copay; up to $100 maximum out-of-network allowance. More frequently if medically necessary (for spectacle or contact lenses only).
Choice Plus Plans*: Adults: Every 24 months, $20 allowance for single lenses, $30 for bifocal, $40 for trifocal or $75 for lenticular.

Children:** Lenses covered in full every 12 months. More frequently if medically necessary.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.}

Benefits apply both In-Network and Out-of-Network

Note: Provider may require payment in full at the time of service. The patient then submits a claim to UHC for reimbursement.

High Deductible Health Plan (HDHP)*: Adults: $100 allowance every 12 months (combined for lenses and frames or contact lenses).

Children:** One pair of eyeglasses (lenses and frames) OR one pair of contact lenses from Essential Health Benefits (EHB) Formulary List (or a 12-month supply) every 12 months with a $75 copay; up to $100 maximum out-of-network allowance. More frequently if medically necessary (for spectacle or contact lenses only).
Choice Plus Plans*: Adults: $30 allowance every 24 months.

Children:** Up to $100 every 12 months. Cost above $100 covered at 60%.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.}

Benefits apply both In-Network and Out-of-Network

Note: Provider may require payment in full at the time of service. The patient then submits a claim to UHC for reimbursement.

High Deductible Health Plan (HDHP)*: Adults: $100 allowance every 12 months (combined for lenses and frames or contact lenses). Medically necessary contact lenses covered at 100% every 12 months.

Children:** One pair of eyeglasses (lenses and frames) OR one pair of contact lenses from Essential Health Benefits (EHB) Formulary List (or a 12-month supply) every 12 months with a $75 copay; up to $100 maximum out-of-network allowance. More frequently if medically necessary (for spectacle or contact lenses only). Medically necessary contact lenses covered at 100% every 12 months.
Choice Plus Plans*: Adults: $75 allowance every 24 months. Medically necessary contact lenses covered at 100% every 12 months.

Children:** Single purchase of a pair of contact lenses or 1 box of contact lenses from Essential Health Benefits (EHB) Formulary List per eye covered at 100% every 12 months. Up to $100 maximum out-of-network allowance. Medically necessary contact lenses covered at 100% every 12 months.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.}

Benefits apply both In-Network and Out-of-Network

Note: Provider may require payment in full at the time of service. The patient then submits a claim to UHC for reimbursement.

Optional Vision Plan

You can elect to purchase Optional UHC Vision coverage in place of the basic vision coverage for you and your covered dependents. You do not have to be enrolled in a medical plan to purchase this coverage.

Monthly Contributions for Optional UHC Vision

Full-Time and Part-Time Officer
Yourself Only: $5.23
Yourself & Child(ren): $12.11
Yourself & Spouse: $9.69
Family: $16.96

In-Network Coverage: Adults: One exam every 12 months with a $10 copay. For pregnant/breastfeeding women and individuals with diabetes, two exams every 12 months with a $10 copay.

Child(ren):* One exam every 12 months plus one additional exam (ages 0-12) with a $10 copay.
Out-of-Network Coverage: Adults: One exam every 12 months, plan pays up to $40. For pregnant/breastfeeding women and individuals with diabetes, two exams every 12 months, plan pays up to $40 per exam.

Child(ren):* One exam every 12 months plus one additional exam (ages 0-12), plan pays up to $40 per exam.

^{* Child is defined as a member less than age 19.}

In-Network Coverage*: Adults: Plan pays 100% every 12 months for single vision, lined bifocal, lined trifocal, or lenticular, including standard scratch coating. Additional costs apply for progressive lenses.

Child(ren):** Plan pays 100% every 12 months for polycarbonate lenses, including standard scratch coating. Replacement frames available if prescription change of 0.5 diopter or more.
Out-of-Network Coverage*: Adults and Child(ren):** Every 12 months, up to $40 allowance for single lenses, up to $60 for lined bifocal, up to $80 for lined trifocal, or up to $80 for lenticular.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.}

In-Network Coverage*: Adults and Child(ren):** $130 allowance every 12 months. Cost above $130 may be covered at 30% at participating providers.***
Out-of-Network Coverage*: Adults and Child(ren): Up to $45 allowance every 12 months.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.

*** 30% discount available at most participating provider locations (in network)—may exclude certain frame manufacturers.}

In-Network Coverage*: Adults and Child(ren):** Up to 4 boxes for covered formulary contacts, including the fitting/evaluation fees and up to 2 follow-up visits covered in full. $130 allowance for non-formulary contacts, 100% for medically necessary contacts.
Out-of-Network Coverage*: Adults and Child(ren):** $130 allowance for elective contacts, up to $210 allowance for medically necessary contacts.

^{* Available for either frames and lenses or contact lenses for adults and children.

** Child is defined as a member less than age 19.}

In-Network and Out-of-Network Coverage: Access to discounted laser vision correction through QualSight LASIK; savings of up to 35% of national average price.

ID Card

UHC ID cards have member information for medical, vision, and prescription drug coverage. You do not need separate cards for each benefit. After enrolling in a medical plan, it can take three weeks for a UHC ID card to arrive in your mail. If necessary, you can print a temporary UHC ID card two weeks after enrolling. Create an account on myuhc.com to print a temporary ID card. Use your Social Security Number, date of birth, and Group number 712790.

Officers - Vision

Routine Eye Exams

Lenses

Frames

Contact Lenses

Monthly Contributions

Monthly Contributions for Optional UHC Vision

Routine Eye Exams

Lenses

Frames

Contact Lenses

Laser Vision Discount

Health & Welfare Benefits

Related Documents

Benefits Tools