The primary purpose of this Network Vision Care Plan is to provide professional eye exams and material discounts to help pay the cost of materials. When obtaining services from a Network doctor, the exam is covered in full, less any applicable co payment. Members receive a 20 percent discount off the Network doctor's usual and customary fees for complete pairs of prescription glasses. The discount includes lenses and lens characteristics chosen for cosmetic reasons. A 15 percent discount applies to the doctor's professional services for all types of prescription contact lenses. This discount applies to professional services only, materials are provided at usual and customary fees.
Exam
$15.00 |
Once every 12 Months |
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Services from a Network Doctor ¹ |
Services from an Out-of-Network Provider |
| Exam |
Covered in Full (after copay) |
Up to $42 (after copay) |
| Complete Pairs of Prescription Glasses |
20 percent discount |
Not Applicable |
| Contact Lens Evaluation & Fitting |
15 percent discount off professional fees(evaluation & fitting) |
Not Applicable |
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Obtaining services from a Network doctor: When you want to obtain vision care services, you call a Federal Chamber of Commerce Network doctor to make an appointment. Make sure you identify yourself as a member of their Network, and be prepared to provide the covered member's social security number and Federal Chamber of Commerce Member ID Number. The Network doctor will contact the vision care service provider to verify your eligibility and plan coverage, and will also obtain authorization for services and materials. If you are not currently eligible for services, the Network doctor is responsible for communicating this to you. The Network Vision Care Provider will pay the doctor directly for covered services and materials.
Obtaining services from an Out-of Network provider: Services obtained from an Out-of Network provider will be reimbursed up to amount on the above schedule less any co payment. For Out-of Network reimbursement, pay the entire bill when you receive services, then send your itemized receipts and full patient and member information to the Network Vision Care Administrator. Claims must be submitted within six months from your date of service. Please keep a copy of the information for your records and send the originals to the Network Vision Care Administrator.
ADDITIONAL BENEFITS:
Laser Vision Correction: A Laser Vision Care program is also available to those covered under this Plan. It is designed to provide members with a discount off laser surgery when obtained through Network Contracted Doctors, Surgeons and Laser Centers. This program includes the two most common laser vision correction procedures, laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Call your Network doctor to check if he or she is participating in the program. Doctors can also be located on the Network Vision Care Administrator's Website and through an toll-free telephone number.
¹ When an exam is received from a Network doctor, the patient will have no out-of-pocket expense other than the co payment.
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THIS IS ONLY A SUMMARY, FOR FURTHER INFORMATION SEE YOUR EMPLOYER'S BENEFIT REPRESENTATIVE
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