Vision
Healthy eyes are vital for overall well-being. You can enroll yourself and dependents in vision coverage separately from medical coverage. You will have less out-of-pocket costs if you go to an in-network provider versus an out-of-network provider.
UHC Vision PPO
Plan Information
Plan Name: UHC Vision PPO
Policy Number: 916243
Effective Date: 01/01/2025
Provider Network: UnitedHealthcare
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Exams
$10 copay
Single Vision Lenses
Covered in full
Bifocal Lenses
Covered in full
Trifocal Lenses
Covered in full
Frames
$150 Allowance
Contacts (in lieu of glasses)
$150 Allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Up to $40 reimbursement
Single Vision Lenses
Up to $80 reimbursement
Bifocal Lenses
Up to $80 reimbursement
Trifocal Lenses
Up to $80 reimbursement
Frames
Up to $45 reimbursement
Contacts (in lieu of glasses)
Up to $125 reimbursement
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months