A vision plan is much more than eyeglasses or contact lenses—it is an integral part of your overall health and wellness. An eye care provider may be able to identify other eye and health issues through a comprehensive eye exam, including macular degeneration, glaucoma, diabetes and high cholesterol.
Vision benefits are an easy way for you and your dependents to maintain healthy vision and eyes. With State of Texas Vision, you can save money on eye exams and eyewear for you and your family with a small monthly premium and low copays.
| BENEFITS | NETWORK | NON-NETWORKFootnote7 |
|---|---|---|
| Exam | $15 copayFootnote1 | Up to $40 after $15 copay |
| Contact lens fitting (standardFootnote2) | $25 copayFootnote1 | Up to$100 retail |
| Contact lens fitting (specialtyFootnote2) | $35 copayFootnote1 | Up to$100 retail |
| Lenses (standard) per pair: | ||
| • Single vision | $10 copayFootnote1 | Up to$30 retail |
| • Bifocal | $15 copayFootnote1 | Up to$45 retail
|
| • Trifocal | $20 copayFootnote1 | Up to$60 retail |
| Lens Options (standard): | ||
| • Progressive | $70 copayFootnote1 | Not covered
|
| • Polycarbonate | Up to $50 copayFootnote1 | Not covered |
| • Scratch coat | Up to $10 copayFootnote1 | Not covered |
| • Ultraviolet coat | Up to $10 copayFootnote1 | Not covered |
| • Tints, solid or gradient | Up to $10 copayFootnote1 | Not covered |
| • Anti-reflective coat | Up to $40 copayFootnote1 | Not covered |
| Frames or Contact LensesFootnote3 | $200 retail allowanceFootnote4, Footnote5, Footnote6 | Up to $75 or Up to $150 retailFootnote8 |
Each benefit in the vision plan can be used once every plan year, per person.
All allowances are at retail value; member is responsible for any amount over the allowance, minus available discounts.
Footnotes
- Covered in full after copay is met.
- A Contact Lens Fitting exam has its own copay and is separate from the eye exam copay. Standard Contact Lens Fitting applies to a current contact lens user who wears disposable, daily wear, or extended wear lenses only. Specialty Contact Lens Fitting applies to new contact wearers and/or a member, who wears toric, gas permeable, or multi-focal lenses.
- Contact lenses are in lieu of eyeglass lenses and frame benefit. This allowance can be used once every plan year.Return to Benefit Table
- All costs and allowances are retail; you are responsible for any charges in excess of the retail allowances.
- The frame allowance allows you to purchase one (1) frame up to $200 with no out-of-pocket cost. If you purchase a frame that costs more than $200, you are responsible to pay the difference. Should you purchase frames that are under $200, you will forfeit the remaining allowance.
- The contact lens allowance of $200 allows you to choose to use the full allowance on one purchase or divide it up throughout the benefit year for multiple contact lens purchases. If your contact lens purchase(s) total more than $200, you are responsible to pay the difference.
- If you use non-network providers, you will be required to pay in-full which will be higher. See the Member Handbook for more information.
- Up to $75 retail reimbursed for non-network frames or up to $150 retail reimbursed for non-network contact lenses.
More information found at https://member.eyemedvisioncare.com/stateoftexasvision/en