Frequently Asked Questions About Vision Coverage

What is the benefit of using an In-Network Provider?The In-Network Providers have all the necessary forms and plan details to assist you with your vision benefits.  They will also provide you with some advantages such as they have each agreed to accept your insurance coverage amounts as full payment at time of service.  This will ensure that you only pay any amounts that exceed your allotted benefits at the time of service.  They will also provide you with 30% off any extra retail items that you purchase.

Who are the In-Network Providers?

• VisionMakers
• Martin G. Ellis, O.D.
• Empire VisionWorks
• Optical Solutions

What should I expect when using an Out-of-Network Provider?

Under the plan, you may choose to use any provider.  However, you will be required to pay your full amount due at the time of your service when receiving services from an out-of-network provider.  Once you have paid your total amounts due, you will need to submit an itemized receipt to VEBA Vision.

Reimbursements are made biweekly and you are only reimbursed for your benefit amounts that are printed on your Vision Benefit Description.

How often am I eligible for benefits?

Coverage will be provided for a comprehensive eye exam and lenses once during any 12 month period; coverage will be provided for frames once during any 24 month period and coverage for contact lenses will be in lieu of coverage for lenses and frames, and will be provided once, during any 12 month period. For example, if you were seen for an eye exam and lenses on April 1, 2011, your next eligibility date would be April 1, 2012.  If you receive contact lenses on April 1, 2011, your next eligibility date would be April 1, 2012.  If you received materials (frames) on April 1, 2011, your next eligibility date would be April 1, 2013.