The AlwaysVision plan is a voluntary benefit that provides comprehensive eye-care benefits when you visit participating providers for services. This plan allows you to obtain eye care with the service provider of your choice and includes Loyola University Health System (LUHS) Ophthalmologists. The chart below describes the plan.
Vision Exam Benefit: Each member is entitled to a comprehensive Vision Exam. An eye exam co-pay applies and is outlined in the grid below.
Vision Materials Benefit: Each member may purchase eyewear in the form of an eyeglass frame and lenses or contact lenses with this plan. Purchases are subject to benefit frequencies and co-pays. Contact lenses may be purchased in lieu of frames and eyeglass lenses. Plan features include:
- Frame Benefit: Members may choose any frame within a provider's collection, subject to the retail frame allowance listed below. If the cost is greater than the plan's benefits, the member is responsible for the difference.
- Eyeglass Lens Benefit: Members always receive new lenses of the highest quality and craftsmanship. Standard plastic (CR-39 Plastic Material) single vision, bifocal and trifocal lenses are generally covered in full and plan allowances are listed below for specialty lenses. If the cost is greater than the plan's benefits, the member is responsible for the difference.
- Contact Lens Benefit: Members electing contact lenses instead of glasses may choose to apply the contact lens retail allowance to any lenses in the provider's collection. If the cost is greater than the plan's benefits, the member is responsible for the difference. The contact lens allowance will apply to the retail cost of contact lenses and to any professional fitting fee charged by the provider.
|Benefit||Loyola Ophthalmologists||Other Participating Providers||Out of Network|
|Exam (every 12 months)||$20 co-pay||$10 co-pay||Up to $45|
|Materials||$15 co-pay||$15 co-pay||See Below|
|Standard Plastic Lenses|
|(every 12 months)|
|Single||Covered by co-pay||Covered by co-pay||Up to $35|
|Bifocal||Covered by co-pay||Covered by co-pay||Up to $58|
|Trifocal||Covered by co-pay||Covered by co-pay||Up to $75|
|Lenticular||$80 allowance||$80 allowance||Up to $50|
|Progressive||$50 allowance||$50 allowance||Up to $40|
|Scratch resistance coating||N/A||N/A||N/A|
|Polycarbonate Lenses for Children||N/A||N/A||N/A|
|(every 24 months)
Members choose from any frame at provider locations
|Up to $150 retail allowance||$150 retail frame—covers a wide selection of frames. ($94 retail frame at Wal-Mart & Sam's Club)||Up to $50|
|(every 12 months)|
|(includes, fit, follow-up and materials)|
|Elective||Up to $150 retail||Up to $150 retail||Up to $125 Retail|
|Medically Necessary||Up to $210 retail||Up to $210 retail||Up to $125 retail|
Selection of Providers
Members may access providers in our nationwide PPO network of 22,000 providers in over 18,000 locations. Options include access to Loyola's Department of Ophthalmology for Well Eye Exams and Contact Lenses, independent Optometrists, plus regional and national retail chains (Pearle Vision, Target, Sears, JC Penney and Eyemasters). Members may choose different providers for vision exam and materials purchases. Out-of-network benefits are available, but members receive the best value in-network.
You may visit www.AlwaysVision.com or call 888.729.5433, Ext. 2013 for a list of participating providers. Most participating providers (excluding Wal-Mart) offer discounts on items purchased after using the insurance benefit.