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Home > Health Plan > Vision Benefit
Vision Benefit
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Teamsters Union Local 170 Health and Welfare Fund is pleased to offer a vision care plan through Davis Vision, Inc., a leading national administrator of routine vision care programs. Eligibility for vision care benefits is determined by the same rules that apply to your medical benefits.
Please feel free to visit our website at: www.davisvision.com or call Davis Vision at 1-800-999-5431 to:
Plan Benefits
What are the plan benefits?
Every 24 months you and your eligible dependents are entitled to:
- A routine eye examination, including dilation as professionally indicated.
- A complete pair of eyeglasses; or,
- Contact lenses (in lieu of eyeglasses)
Please Note: All people cannot wear Contact Lenses, once the contact lens option is selected and the lenses are fitted, they may not be exchanged for eyeglasses.
Routine eye examinations do not include professional services for contact lens evaluations. Any applicable fees are the responsibility of the patient.
a. Members only may receive, a second pair of eyeglasses with a $25. 00 copayment.
b. Dependent Children up to the age of 19 will be entitled to an annual eye examination, including dialation as professionally indicated, frame and spectacle lenses or contact lenses in lieu of eyeglasses.
Network Doctors
Who are the network doctors?
They are licensed doctors who are extensively reviewed and credentialed to ensure that stringent standards for quality service are maintained. Please call 1-800-999-5431 to access the Interactive Voice Response (IVR) Unit, which will provide you with the names and addresses of the network doctors near you , or you may access our website at www.davisvision.com and utilize our “Find a Doctor” feature.
How do I receive services from a doctor in the network?
- Call the network doctor of your choice and schedule an appointment
- Identify yourself as a Teamsters Union Local 170 Health and Welfare Fund member or dependent
- Provide the office with the member’s Social Security number and the year of birth of any covered children needing services
It’s that easy! The doctor’s office will verify your eligibility for services, and no claim forms are required!
Eyewear Selections
Whay types of eyewear may I select?
- Any frame from the special Premier selection*, (with equivalent retail values up to $175.00), displayed on the “Tower Collection” in most network doctor’s offices, or a $14.00 credit will be applied toward the purchase of a frame from the doctor’s private selection
*Members only may select two pairs
- Any spectacle lens type; most are included with no copayment (see below)
- Contact lenses, in lieu of eyeglasses; standard, soft, daily-wear, disposable or planned replacement types are available for most prescriptions with a copayment (see below). A $45.00 credit will be applied toward other types of contact lenses (i.e., toric or gas permeable from the doctor’s private selection), fitting fees, and recommended follow-up care
Please note: All people cannot wear Contact lenses, once the contact lens option is selected and the lenses are fitted, they may not be exchanged for eyeglasses
What lenses / coatings are included?
- Plastic or glass single vision, bifocal or trifocal lenses, in any prescription range
- Glass gray #3 prescription lenses
- Oversize lenses
- Post-cataract lenses
- Fashion, sun or gradient tinted plastic lenses
- Scratch-resistant coating
- Polycarbonate lenses
- Ultraviolet (UV) coating
- Progressive addition multifocals. ****** Progressive addition multifocals can be worn by most people, but not by all. Conventional bifocals will be supplied at no additional costs for anyone who is unable to adapt to progressive addition lenses.
The following are included for one pair only:
- Blended invisible bifocal
- Photogrey Extra® (photosensitive) glass lenses
Are there any optional lens types or coatings available?
Yes, you can pay the low, discounted fixed fees indicated and receive these exciting optional items:
- $35.00 for standard ARC (anti-reflective coating). Premium ARC is $48.00
- $30.00 for intermediate vision lenses.
- $65.00 for plastic photosensitive lenses
- $55.00 for high-index (thinner and lighter) lenses
- $75.00 for Polaroid lenses
When will I receive my eyeglasses?
Your eyewear will be sent to your doctor from the laboratory generally within two to five business days. Additional delivery time may be required when out-of-stock frames, glare resistant treatment, specialized prescriptions or non-“Tower Collection” frames are selected.
Cost for Services
What are my costs for services?
- No copayment is required toward your eye examination
- No copayment is required toward most spectacle lenses
- No copayment is required toward a Premier frame from the “Tower Collection”. A complete benefit (frame and lenses) from the “Tower Collection” could have a comparable retail value up to $275.00! Members only may select a second pair from the Designer Collection for $25.00
- A $25.00 or $45.00 copayment will be required toward standard, soft” daily-wear, disposable** or planned replacement contact lenses in lieu of eyeglasses. Your doctor will provide specific copayment information for the type of lenses you require
* * New (to the doctor, or first-time) contact lens wearers will receive an initial supply (two multi-packs) of lenses, along with all necessary visits for proper fitting and recommended follow-up care. Existing contact lens wearers will receive four multi-packs of lenses
Contact Lenses
More Special Features
- Free membership and access to Lens 1-2-3®, a mail order replacement contact lens service providing a fast and convenient way to purchase replacement contact lenses at significant savings. For more information, please call 1-800-LENS-123 (1-800-536-7123)
- A one year unconditional breakage warranty is provided for all eyeglasses completely supplied by Davis Vision
Information about Laser Vision Correction Services:
Davis Vision is pleased to provide you and your eligible dependents with the opportunity to receive Laser vision Correction Services at significant discounts through a network of experienced, credentialed surgeons (please note that some providers have flat fees equivalent to these discounts). For more information, please visit our website at www.davisvision.com or call 1-800-584-2866, and enter client code 7916.
Out-of-Network Provider Benefits
What about out-of-network provider benefits?
You may receive services from an out-of-network provider, although you will receive the greatest value and maximize your benefit dollars if you select a doctor who participates in the network.
If you choose an out-of-network provider, you must:
- Pay the provider directly for all charges
- Submit a claim for reimbursement to:
Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110
Services will be reimbursed up to the following schedule of maximums:
| |
Eye examination |
$30.00 |
| |
Single vision lenses |
$30.00 (per pair) |
| |
Bifocal lenses |
$50.00 (per pair) |
| |
Trifocal lenses |
$50.00 (per pair) |
| |
A frame |
$22.00 |
Contact lenses
| |
Standard Lenses |
$30.00 |
| |
Aphakic Lenses |
$30.00 |
To request claim forms, please call 1-800-999-5431.
May I use the benefit at different times?
All available services must be obtained at one time from either a network or an out-of-network provider.
Exclusions
The following items are not covered by this vision program:
- Medical treatment of eye disease or injury
- Vision therapy
- Special lens designs or coatings, other than those previously described
- Replacement of lost eyewear
- Non-prescription (plano) lenses
- Services not performed by licensed personnel
Need more information?
Please feel free to visit our website at: www.davisvision.com or call Davis Vision at 1-800-999-5431 to:
- Locate a network doctor in your area
- Verify eligibility for yourself or a family member
- Request an out-of-network provider reimbursement claim form
- Speak with a Member Service Representative
- Ask any questions about your vision benefits
Member Service Representatives are available
Monday through Friday, 8:00 AM to 8:00 PM, Eastern Time
Saturday, 9:00 AM to 4:00 PM, Eastern Time
T.D.D. (Telecommunications Device for the Deaf) services are available by calling 1-800-523-2847.
Sponsored by, and administered on behalf of the members and dependents of Teamsters Union Local 170 Health and Welfare Fund.
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