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Vision Coverage
Vision coverage through UnitedHealthcare.
Vision Premium Contributions
| Coverage Tier | Per-Paycheck Contribution |
|---|---|
| Employee Only | $0.00 |
| Employee + Spouse | $2.53 |
| Employee + Child(ren) | $2.33 |
| Employee + Family | $4.89 |
Employee Only
- Per-Paycheck Contribution
- $0.00
Employee + Spouse
- Per-Paycheck Contribution
- $2.53
Employee + Child(ren)
- Per-Paycheck Contribution
- $2.33
Employee + Family
- Per-Paycheck Contribution
- $4.89
Benefit Frequency
| Service | Frequency |
|---|---|
| Eye Exam | Once every 12 months |
| Frames | Once every 12 months |
| Lenses | Once every 12 months |
| Contact Lenses (in lieu of glasses) | Once every 12 months |
Eye Exam
- Frequency
- Once every 12 months
Frames
- Frequency
- Once every 12 months
Lenses
- Frequency
- Once every 12 months
Contact Lenses (in lieu of glasses)
- Frequency
- Once every 12 months
Coverage Details
| Service | In-Network | Out-of-Network Reimbursement |
|---|---|---|
| Exam | $10 | Up to $40 |
| Materials Copay | $10 | N/A |
| Frames | Covered up to $180 | Up to $45 |
| Single Vision Lenses | $10 | Up to $40 |
| Bifocal Lenses | $10 | Up to $60 |
| Trifocal Lenses | $10 | Up to $80 |
| Contact Lenses | Covered up to $150 | Up to $125 |
Exam
- In-Network
- $10
- Out-of-Network Reimbursement
- Up to $40
Materials Copay
- In-Network
- $10
- Out-of-Network Reimbursement
- N/A
Frames
- In-Network
- Covered up to $180
- Out-of-Network Reimbursement
- Up to $45
Single Vision Lenses
- In-Network
- $10
- Out-of-Network Reimbursement
- Up to $40
Bifocal Lenses
- In-Network
- $10
- Out-of-Network Reimbursement
- Up to $60
Trifocal Lenses
- In-Network
- $10
- Out-of-Network Reimbursement
- Up to $80
Contact Lenses
- In-Network
- Covered up to $150
- Out-of-Network Reimbursement
- Up to $125
Important Notes
- You will maximize your benefits and lower your out-of-pocket costs by choosing a provider in the UHC Vision Network. Find one at https://www.whyuhc.com/vision.
- If you use an out-of-network provider, you pay the provider in full at your appointment and submit a claim form for reimbursement up to the amount allowed by the plan.