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Contact Lens Information: VISION PLAN OF AMERICA For All Plans A - B - C
COSMETIC CONTACT LENSES are available in addition to the basic benefit (see Schedule of Extras ); OR , if desired in lieu of all other services, after the deductible is paid, $100 applies to the doctor's usual and customary package fee, which includes the eye examination, fitting and contact lenses. Cosmetic Contacts are available every 12 months for plans A and B; every 24 months for plan C.
$100 may also apply toward an annual supply of disposable contact lenses. Fitting may have an added cost.
Cosmetic Contact Lenses must be arranged for and purchased at the time of the initial eye examination and fitting. If the member wants only the contact lens prescription; after the deductible is paid, use the Schedule of Extras for the work up fee. The $100 only applies to the package fee, which includes eye examination, fitting and contact lenses.
* MEDICALLY NECESSARY CONTACT LENSES are available every 24 months. This benefit includes a contact lens examination, fitting, follow up visits, and Medically Necessary lenses. The Plan pays up to $250 towards this benefit.
* When visual acuity cannot be corrected to 20/70 or better by standard means (eyeglasses), medically necessary contact lenses may be indicated, as in (Keratoconus, Anisometropia or Cataract surgery). Prior approval is necessary, please contact Vision Plan of America for the proper form or find the form in the “Provider Reference Guide” and return it to the Medical Director by mail or fax for approval.
Guidelines for Contact Lens Fitting
• It appears under the new State Law ( Legislative Counsel's Digest AB 2020) the provider must release contact lens prescription for soft contact lenses (exceptions: custom lens, specialty lenses, and RGP lenses).
• Under the benefit plans offered by Vision Plan of America (Plans A, B, C), the contact lens benefit applies to the doctor's annual package fee (examination, fitting, follow-up, and contact lenses). It is in the best interest of the patient to receive a complete eye examination as opposed to the fitting of new contact lenses from an old prescription or an eyeglass prescription.
• The contact lens portion of the benefit was designed to allow the member to access care from the primary eye care provider and allow them the benefit contact lenses at a greatly reduced cost.
• What happens if a member comes in with a valid prescription and wants to purchase contact lenses only?
$100 applies to the annual contact lens supply purchase, only with a valid contact lens prescription or, if a regular eyeglass prescription is prescribed a fitting fee may apply. The $100 applies toward the doctor's annual lens supply fee. i.e. a supply of 2 week disposable contact lenses = 8 boxes (6 lenses each box), etc, as an example of an annual supply.
Vision Plan of America
Contact Lens Information
Have Questions? Call (800) 400-4872
Individual + 1 Dependent $17.60
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