coverage

Vision Coverage

Plan A	Plan B
In-Network	In-Network
WellVision Exam focuses on your eye health and overall wellness $10.00 copay .............................. every 12 months Prescription Glasses Discounts Lenses - 20% discount when a complete pair of glasses is purchased. Frames - 20% discount when a complete pair of glasses is purchased. Contacts 15% discount off the contact lens fitting and evaluation exam. This exam is in addition to your vision exam to ensure proper fit of contacts.	WellVision Exam focuses on your eye health and overall wellness $10.00 copay .............................. every 12 months Prescription Glasses $25.00 copay Lenses - Every 12 months - Single vision, lined bifocal and lined trifocal lenses; Polycarbonate lenses for dependent children Frame - Every 24 months. $130.00 allowance for a wide selection of frames. Plus, 20% off the amount over your allowance. ~OR~ Contacts (instead of glasses) Every 12 months. Up to $60.00 copay for your contant lens exam (fitting and evaluation) $130.00 allowance applies to the cost of your contacts
Extra Discounts & Savings	Extra Discounts & Savings
Laser Vision Correction Discounts Average 15% off the regular price or 5% off the promotional prices; discounts only available from contracted facilities Glasses and Sunglasses Up to 20% savings on lens options such as progressives and scratch resistant and anti-reflective coatings 20% off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last WellVision Exam Contacts 15% off cost of contact lens exam (fitting and evaluation)	Laser Vision Correction Discounts Average 15% off the regular price or 5% off the promotional prices; discounts only available from contracted facilities After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor Glasses and Sunglasses Average 35- 40% savings on all non-covered lens options 30% off additional glasses and sunglasses, including lens options, from the same VSP doctor on the same day as your WellVision Exam. Or get 20% off from any VSP doctor within 12 months of your last WellVision Exam Contacts 15% off cost of contact lens exam (fitting and evaluation)
Copays	Copays
Exam............................................$10.00	Exam........................................$10.00 Prescription Glasses...................$25.00 Contacts........................... up to $60.00
Out-of-Network Reimbursement Amount	Out-of-Network Reimbursement Amount
Exam.....................................Up to $50.00	Exam...............................Up to $50.00 Single Vision....................Up to $50.00 Lined Bifocal....................Up to $75.00 Lined Trifocal...................Up to $100.00 Frame.............................Up to $70.00 Contacts..........................Up to $105.00

UCM - P.O. Box 800 - Warrensburg MO 64093 |
877-729-8266 |
Campus Operator: 660-543-4111 |

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UCM
P.O. Box 800
Warrensburg, MO 64093
877-729-8266
Campus Operator
660-543-4111
General Information admit@ucmo.edu

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