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Vision
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For Services incurred prior to January 1, 2011 the vision plan is with HMA.
For Services effective January 1, 2011 the vision plan has changed to UMR.
Effective January 1, 2012 SPEU Kaiser Medical members have a Kaiser $250 vision plan. See the Kaiser Summary of Benefits for details.
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UMR PPO Vision
Traditional Plan (Core)
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Pays based on a usual and set customary rate fee schedule.
Examinations (including refractions) available once every 12 months -
- Participating provider 100%
- Non-participating provider $25.00 maximum benefit
Lenses are available once every 12 months
- $89.00 single lenses
- $125.00 bifocal lenses
- $158.00 trifocal lenses
- $50.00 lenticular lenses
Frames are available once every 24 months- $40.00
Contact lenses - maximum $100 per calendar year |
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UMR PPO Vision
$250 Plan (Buy-up)
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The $250 Vision plan pays for routine vision examinations, corrective lenses, frames and contacts when prescribed by an ophalmologist or optometrist. As per Healthcare Reform, children age 0-18 have 100% routine vision exam coverage if services are with a preferred provider and the $250 benefit will apply for hardware. Members age 19 and above have the $250 combination vision plan.
Age 0-18
- Exams (including refraction)-Once every 12 months.
- Participating provider 100%, Non-participating provider 60%.
- Hardware-any combination of corrective lenses, frames and contact lenses up to maximum $250 every calendar year per enrolled person.
Age 19 and above
$250 maximum every calendar year per enrolled person for any combination of routine exams, corrective lenses, frames and contact lenses.
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| Kaiser Vision |
Effective January 1, 2012 SPEU members with Kaiser medical have a Kaiser vision plan. Services must be performed at Kaiser clinics as per Kaiser Permanente guidelines.
- Routine Exams $15.00 co-pay
- Prescription lenses, frames and contact lenses up to $250 maximum per enrolled person every 12 months
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