Department of Management Services

Vision Insurance Plan

Caring for your eyes is a very important part of your overall health and wellness. That's why the State offers you competitive vision coverage at affordable rates through Humana Vision (Adobe PDF Document 473.58 KB). Coverage is available to retirees through COBRA and to COBRA participants if they were enrolled prior to termination. Find out if you are eligible for these benefits.

 

Exam and Materials (Plan 3004)
Monthly Member Rates
Employee Only $6.32
Employee + Spouse $12.48
Employee + Children $12.34
Family $19.38
Frequency (based on the date of service)
Exam Every 12 months
Lenses Every 12 months1
Frames Every 24 months
Co-payments
Exam $10.00
Lenses and/or Frames $10.00
Benefits
Network Out-of-Network
Eye Exam 100% after co-pay $40 allowance
Lenses 1
  Single 100% after co-pay $40 allowance
  Bifocal 100% after co-pay $60 allowance
  Trifocal 100% after co-pay $80 allowance
  Frames $75 wholesale $60 retail
Contact Lenses 2
   Elective3 $150 allowance $75 allowance
   Medically Necessary4 100% $100 allowance
Lasik We have contracted with many well-known facilities and eye doctors to offer Lasik procedures at substantially reduced fees. You can take advantage of these low fees when procedures are done by network providers. Participants receive a 25 percent discount off the usual and customary price or a five percent off advertised promotions or specials for LASIK services provided by in-network providers, whichever discount is greater. The discount includes consultations, laser procedure, follow-up visits and any additional necessary corrective procedures.
Calendar Year Deductible None, after plan co-payments
Calendar Year Maximum Benefit Up to plan limits
Lifetime Maximum Benefit Unlimited
Waiting Periods None

 

For more detail, visit the Humana Vision Web site.

1 You can purchase either glasses or contact lens. Coverage applies to one or the other.

This allowance is paid with the same frequency as lenses, in the place of the lens and frame benefit.

The contact lens allowance applies to evaluation and fitting fee, if applicable, and materials. Members may be eligible to receive up to a 15 percent discount on participating provider professional services.

4 Medically necessary (prior authorization required) is defined as 1) following cataract surgery without intraocular lens; 2) correction of extreme visual acuity problems not correctable with glasses; 3) anisometropia greater than 5.00 diopters and asthenopia or diplopia, with spectacles; 4) Keratoconus; or 5) monocular aphakia and/or binocular aphakia where the doctor certifies contact lenses are medically necessary for safety and rehabilitation to a productive life.