Vision Care

 

What are my Vision Care options?

The Fund has two vision care programs, the Preferred Provider Vision Plan and the Alternative Vision Plan.

You do not need to choose between the two vision plans when you complete your annual enrollment form. Eligible employees and most dependents may receive the vision benefit once every 24 months. Dependents age 14 and under may receive a vision benefit once every 12 months.

 Top of page

 

What is the Preferred Provider Vision Plan?

Under this Plan, you must receive services from a Preferred Vision Provider. An automated Provider Locate Sstem, supplying you with a recorded list (or printed list, upon request) of the Preferred Vision Providers nearest your home, can be accessed by calling (800) 406-1656. You may also visit www.davisvision.com for a complete listing of participating providers.

To receive services from a Preferred Vision Provider of your choice, simply contact the Preferred Vision Provider and schedule an appointment. If you have used the benefit before, you should call the Vision Care Processing Unit at (800) 406-1656 to confirm that it has been at least 24 months, or 12 months if you are 14 or younger, since you last received services.

The Preferred Provider Vision Plan benefit includes a comprehensive eye examination (including dilation, as professionally indicated) upon payment of a $10 co-payment, and one pair of prescription eyeglasses from the Designer-Metal Plan Frame Collection at no cost. You can obtain other optional lens types and coatings if you make the required co-payment. Please reference the Preferred Provider Vision Plan: Services and Fees Table for payment information. In lieu of one pair of eyeglasses, Plan supplied contact lenses are available for most prescriptions upon payment of a required $50 co-payment.

You may also purchase a second pair of prescription eyeglasses from the Plan Frame Collection at a discounted wholesale price when you use your vision benefit with a Preferred Vision Provider. The Plan Frame Collection includes over 250 stylish eyeglass frames.

Members who wish to use the Preferred Provider Vision Plan must obtain their services from a participating vision provider. Currently, over 300 vision care offices located throughout Massachusetts and the surrounding area participate in the Davis Vision Preferred Provider Vision Plan. To obtain the most current list of Vision Care Providers, visit DavisVision.com or contact the Vision Care Unit at (800) 406-1656 for a printed list.

Top of page

How do I locate a Preferred Provider Vision Provider?

An automated Provider Locate System, supplying you with a recorded list (or printed list, upon request) of the Preferred Vision Providers nearest your home, can be accessed by calling (800) 406-1656. You may also visit www.davisvision.com for a complete list of participating providers.

Top of page

 

How do I receive services under the Preferred Provider Vision Plan?

First, call the Vision Care Processing Unit at (800) 406-1656 to verify your eligibility for services and to locate a participating Preferred Vision Provider, and be sure to identify yourself as a member of the Massachusetts Public Employees Fund when you make your appointment. Your Preferred Vision Provider will handle the paperwork: Claim Forms are not required. After you have received services, your Preferred Vision Provider will ask you to sign and date a Service Record Form verifying your receipt of services. If you obtain any services or materials which require a member co-payment, you must pay the Preferred Vision Provider directly.

Call Davis Vision at (800) 406-1656 or visit www.davisvision.com to locate a Preferred Visin Provider or to confirm that your provider still participates in the Davis Vision Preferred Provider Vision Plan.

 

Top of page

 

What is the Alternative Vision Plan?

The Alternative Vision Plan is a reimbursement program. This plan allows you to obtain services and materials from any vision care provider you choose. After you pay for your vision care services and materials, you receive partial reimbursement for the cost of an examination and one pair of prescription eyeglasses or contact lenses. A complete list of covered Alternative Vision Plan services and the Fund’s maximum reimbursement amounts is listed in the alternative vision plan services and fees schedule.

 

Top of page

 

How do I file a claim under the Alternative Vision Plan?

First call the Vision Care Processing Unit at (800) 406-1656 to verify your eligibility for services and to order a Claim Form. Bring your Claim Form with you when you go for services. Your vision provider(s) should complete the applicable sections of the form when services are rendered. You then submit the completed, signed form and an itemized bill from the provider to:

Vision Care Processing Unit
P.O. Box 1525
Latham, New York 12110

You are responsible for paying your provider’s bill in full. After you submit your completed Claim Form and the provider’s itemized bill, you will be reimbursed according to the alternative vision plan services and fees schedule.

 

Top of page

Can I get an exam now and order materials (lenses and frames) at a later date?

The three parts of the vision benefit (examination, lenses, frames) may not be split between two time periods. They may not be split between a Preferred Vision Plan provider and an Alternative Vision Plan provider, or between two full-service (examination and eyewear dispensing) Preferred Vision Plan providers.

If your Preferred Provider is a full service office (examinations and dispensing) you must receive all of your vision benefit on the same day. For example, if you have an exam and need glasses, you must order your lenses and frames on the day of your examination.

If you receive your examination from a Preferred Provider that performs examinations only, and you need materials (lenses and frames), you must visit a Preferred Provider that dispenses eyewear only within 30 days of your examination.

Top of page

 

Are there any limitations or exclusions under either Plan?

If the Plan booklet does not expressly provide for a vision benefit or service, such benefit or service shall not be covered under either vision plan. In addition, the following limitations and exclusions apply to both the Preferred Provider Vision Plan and the Alternative Vision Plan:

  • You are your covered dependents are eligible to receive the vision benefit once every 24 months(and your children age 14 and under are eligible once every twelve months) from the date of your last service. There is no additional coverage in the event of lost or stolen eyewear, or if a medical condition necessitates more frequent exams and/or materials;
  • Non-prescription eyeglasses are not covered by either plan;
  • Benefits for medical treatment of an eye injury or an eye disease are not provided under either plan;
  • No benefits will be paid under either plan for non-covered plan services or materials, including vision training, nor will reimbursement be made for any vision services or supplies for which you or your dependents are not required to pay or for any charges that would not have been made if no Fund coverage was available.

 

Top of page

Davis Vision Preferred Vision Providers

Please call Davis Vision at (800) 406-1656 or visit www.davisvision.com to locate a Preferred Vision Provider or to confirm that your provider still participates in the Davis Vision Preferred Provider Vision Plan.

Top of page