Vision insurance is available to all state and higher education employees and dependents. For local education and local government, this option is only available if offered by your agency. Check with your agency benefits coordinator to see if you are eligible.
Eligible employees can choose from two plans: Basic Plan and the Expanded Plan. Both plans offer the same services, including:
|•||Annual routine eye exam|
|•||Discount on Lasik/Refractive surgery|
What you pay for services depends on the plan you choose. With the Basic Plan, you pay a discounted rate or the plan pays a fixed-dollar allowance for services and materials. The Expanded Plan provides services with a combination of copays, allowances and discounted rates. See the benefit chart to compare benefits in both plans.
As with other optional products, the state's vision insurance is an employee pay-all option. This means the state does not pay any part of the premium. Members are responsible for the full premium.
The Basic and Expanded Plans are both administered by EyeMed Vision Care. Our network is the Select Network. You will receive the maximum benefit when visiting a provider in the Select network. However, out-of-network benefits are also available.
General Limitations and Exclusions
The following services are not covered under the vision plan:
|•||Treatment of injury or illness covered by workers' compensation or employer's liability laws|
|•||Cosmetic surgery and procedures|
|•||Services received without cost from any federal, state or local agency|
|•||Charges by any hospital or other surgical or treatment facility and any additional fees charged for treatment in any such facility|
|•||Services by a vision provider beyond the scope of his or her license|
|•||Vision services for which the patient incurs no charge|
|•||Vision services where charges exceed the amount that would be collected if no vision coverage existed|
Note: If you receive vision services and materials that exceed the covered benefit, you will be responsible for paying the difference for the actual services and materials you receive.