Benefits - Infonet

Vision Coverage

Learn About Your Vision Coverage

(PDF)

Using Your Vision Coverage

Your provider must verify your coverage prior to your appointment. Some VBA providers can do this electronically, but many require a paper claim voucher. If your provider uses paper vouchers, you must contact VBA and request one prior to scheduling your appointment. If your provider has implemented VBA’s new electronic benefit authorization system, a paper form is not required - they can now obtain an electronic authorization on your behalf. To choose a provider from VBA’s extensive network for the highest level of benefits and to find out if they use paper or electronic verifications, visit the VBA website.

Questions?
Contact VBA via UPMC DirectLink at
1-800-994-2752, option 2.

Vision benefits are included with all medical coverage options. These benefits are administered by Vision Benefits of America (VBA). If you are enrolling in a medical coverage option, you may choose between the Standard and Enhanced vision options. If you are not enrolling in a medical option, the Enhanced Vision benefit may be purchased separately. Refer to your My HUB benefit enrollment for per-pay contributions.

Standard Vision Option

Included in the cost of medical coverage.

$50 wholesale allowance toward eyeglass frames, representing a $100 to $135 retail value.

An eye exam and frames with lenses or contacts (within allowances) may be obtained once every 24 months for adults, including full-time students ages 19 to 25. An eye exam and lenses or contacts (within allowances) every 12 months, frames once every 24 months, for children younger than age 19.

Enhanced Vision Option

Can be purchased by eligible staff with or without electing medical coverage.

$60 wholesale allowance toward eyeglass frames, representing a $120 to $160 retail value.

An eye exam and frames with lenses or contacts (within allowances) may be obtained once every 12 months for adults and children.

Covered
Services

Vision network
provider

Non-network
provider

Eye exam

100%

$40

Lenses
   single
   bifocal
   blended bifocal
   trifocal
   lenticular
   progressive *

$15 Copay
100%
100%
100%
100%
100%
available

$40
$50
$50
$75
$100
$75

Frames

100%**

$50

Contact lenses
• selected instead
of glasses
• medically required

$150***

UCR****

$150

$300

Low vision aids

UCR ****

$500

* Progressive lenses available in-network at an additional cost, ranging from
$45 to $130 (typically $175 to $350)
** $50 wholesale allowance for Standard Option; $60 wholesale allowance for Enhanced Option
*** Includes contact lenses and eye exam
**** Usual, customary, and reasonable as determined by VBA

Benefits described may not be applicable to all staff. Some business units have unique benefit programs, certain job classifications may affect benefit eligibility, and contract terms determine benefits for physicians and members of collective bargaining units.