Vision
Fully insured Vision Care benefits will continue to be offered by Superior Vision Care.
Superior Vision continues to build and enhance their network and administration. Earlier this year, Sam’s Club joined the Superior Vision network. Additional providers can be found by accessing the website at www.superiorvision.com/ut.
| Covered Services1 |
Network Benefits |
Out-of-Network Benefits |
| Comprehensive eye exam by an ophthalmologist or optometrist |
Covered in full after $35 Copay, but does not include the contact lens exam or fitting fees2 |
Up to $42 (ophthalmologist)
Up to $37 (optometrist)
|
| Standard lenses (per pair) - plastic (CR39), clear, uncoated |
Covered in full |
Up to $32 (single vision)
Up to $46 (bifocal)
Up to $61 (trifocal)
Up to $84 (lenticular) |
| Frames |
Covered in full up to $140 retail |
Up to $53 |
| Contact lenses |
Covered in full (non-elective)
medically necessary)3
Up to $125 retail (elective/cosmetic)3 |
Up to $210 (non-elective/
medically necessary) 3
Up to $100 (elective/cosmetic)3 |
1Only one comprehensive exam is covered per plan year. Only one pair of eyeglass lenses and one set of frames or one contact lens allowance is covered per plan year.
2Comprehensive eye exam subject to a $35 Copay (network only)
3Contact lenses in lieu of eyeglass lenses and one set of frames
Contact Lenses
Contact lenses (non-elective/medically necessary) are covered in full for members who have one or more of these medical conditions*:
- Aphakia
- Anisometropia
- Kerataconus
- When visual acuity cannot be corrected to 20/70 in the better eye except through the use of contact lenses
*Prior authorization is required.
Contact lenses (elective) are also covered for those who prefer to wear contacts instead of glasses.
Mail order contact lenses are available at www.SVContacts.com.
LASIK Procedure
Superior Vision offers discounted rates off the usual and customary prices for LASIK surgery. These discounts vary depending on the provider but are the best possible discounts available to Superior Vision.
Additional Features
- 20% discount on upgrades and add-ons to the eyeglass lens benefit from Network providers on the first insured pair
- 20% discount on additional purchases of non-disposable contact lenses
- 30% discount on additional purchases of eyeglasses (frame and lens)
- 10% discount on additional purchases of disposable contact lenses
NOTE: These discounts are available from specific providers contracted to honor the Discount Plan. Two providers that do not participate in the Discount Plan are Wal-Mart Vision Centers and Sam’s Clubs. Please check the Superior Vision website for additional confirmation of Discount Plan providers.
Introducing… Superior Vision’s SmartAlert Program!
Superior Vision’s SmartAlert provides an easy way to foster communication between you, your Superior Vision eye care provider and your primary care physician or specialist. Vision exams can play an important role in the accurate diagnosis and monitoring of conditions, which may impact your total wellness or larger health issues. The SmartAlert program provides you and your Superior Vision eye doctor an important conduit for sharing the findings of your eye exam, at your discretion, with your primary care physician or wellness plan administrator.
SmartAlert includes a valuable member tool to assist you in preparing and sharing information about your lifestyle and environment with your Superior Vision provider. This tool is the My Vision Lifestyle Update* form and is located on the Superior Vision website at www.superiorvision.com in the Member portal. You should print a copy of the form, review and answer the questions carefully, then share this form with your Superior Vision provider during your next eye exam appointment.
