Vision

Your vision benefits are provided by Vision Service Plan (VSP).

How to use your benefits:

  1. Call your VSP doctor and make an appointment.
  2. When you call, tell the doctor you are a VSP member and give the following information:
    • Your name and date of birth
    • The name of the group that provides your VSP coverage (Operating Engineers)
  3. Covered member's VSP identification number (usually the Social Security number)*
    *The covered member is the person whose group provides your VSP coverage. If it's not your group that provides you with VSP, then it's probably your spouse or a parent.
  4. After you make an appointment, your doctor and VSP will handle the rest. The doctor will check your eligibility for services and plan coverage.

VSP Plan Summary

Maximum Calendar Year Benefit

No overall calendar-year limit

Copayment

$7.50 per individual, payable for the first service rendered each year

Item

VSP Provider

Non-VSP Provider

Exam (once every 12 months)

Covered in full

Plan reimburses up to $37

Frames (once every 24 months)

Covered up to Plan allowances

Plan reimburses up to $40

Eyeglass Lenses (once every 12 months when warranted by prescription change)

 

 

·        Single Vision

Covered in full

Plan reimburses up to $34 per pair

·        Bifocal

Covered in full

Plan reimburses up to $51 per pair

·        Trifocal

Covered in full

Plan reimburses up to $68 per pair

·        Lenticular

Covered in full

Plan reimburses up to $100 per pair

Contact Lenses (once every 12 months)

 

 

·        Visually necessary

Plan pays 75% of cost (with prior approval from VSP)

Plan reimburses up to $126 for professional fees and materials

·        Elective

Professional fees and materials covered up to $100

Plan reimburses up to $100 for professional fees and materials

Low Vision Benefit

Maximum Benefit

$500 (after copayment) every two (2) years

Copayment

50% of VSP provider charges for supplemental aids

Item

VSP Provider

Non-VSP Provider

Supplemental Testing

Covered in full

Plan reimburses up to $125

Supplemental Care Aids

Plan covers 50% of cost

Subsequent low vision aid as visually necessary or appropriate

Plan reimburses up to 50% of what VSP provider would charge

Subsequent low vision aid as visually necessary or appropriate

Kaiser Plan Summary

The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Kaiser "Evidence of Coverage.    

Vision Benefit

$5 co-pay per visit; $150 allowance for eyeglasses purchased from Plan optical sales office, every 24 months.

Health Net Plan Summary

The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Health Net "Evidence of Coverage.    

Vision Benefit $5 co-pay for exam; no charge for standard eyeglass lenses, available every 24 months or every 12 months if prescription change; $100 frame allowance every 24 months (member pays 80% of remaining balance).    

Contact Lenses  in lieu of glasses  

Conventional/Cosmetic: (one pair every 24 months) – Health Net Vision pays the first $100, and member pays 85% of remaining balance.   Disposable/Cosmetic: (You need to purchase enough pairs to reach the allowable amount at one visit. If you do not use the full $100 allowed amount during the initial purchase, the remaining balance will not carry over.) – Health Net Vision pays the first $100, and member pays the remaining balance  

Medically necessary: (one pair every 24 months) – Health Net Vision pays the first $250, and member pays the remaining balance

PacifiCare Plan Summary

The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Plan's Benefits Summary and "Evidence of Coverage".  

Vision Benefit

$15 co-pay for exam, every 12 months; Materials not covered.