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Public Entity Members

Vision Plan

Check with your employer to see if this plan is offered.

National Vision Administrators, L.L.C. (NVA) offers vision benefits through a nationwide network of participating providers. Basic and premium plans are offered with specific copayments for services from network proivders. Both plans offer allowances for services from non-network providers. These plans do not replace medical coverage for eye disease or injury.

When receiving services from a network provider, NVA pays the provider directly. When receiving services from a non-network provider, members pay the provider and file the claim. Reimbursement checks for non-network claims may take up to 30 days to process. In Missouri, members may be required to pay the full retail amount and not the negotiated discount amount at certain participating providers.

To view the provider directory or for more information, contact NVA.

Benefit Chart
BENEFITS NETWORK NON-NETWORK
Exams — once every calendar year — two annual exams covered for children up to age 18 Exams — once every calendar year — two annual exams covered for children up to age 18
Vision Exam Network — $10 copayment Non-Network — Reimbursed up to $45
Lenses — once every calendar year; copayment applied to all lens options Lenses — once every calendar year; copayment applied to all lens options
Single-vision lenses (per pair) Network — $25 copayment Non-Network — Reimbursed up to $30
Bifocal lenses (per pair) Network — $25 copayment Non-Network — Reimbursed up to $50
Trifocal lenses (per pair) Network — $25 copayment Non-Network — Reimbursed up to $65
Lenticular lenses (per pair) Network — $25 copayment Non-Network — Reimbursed up to $100
Polycarbonate lenses (per pair)
Applies to children up to age 18
Network — 100% coverage Non-Network — Not covered
Premium Plan Only
Standard anti-reflective coating
Network — $30 copayment Non-Network — Not covered
Premium Plan Only
Standard progressive multifocal
Network — $50 copayment Non-Network — Not covered
Frames — once every two calendar years; once every calendar year for children up to age 18 Frames1 — once every two calendar years; once every calendar year for children up to age 18
Frames1 Basic Plan
Network — Up to $125 retail allowance and 20% discount off remaining balance

Up to $55 Every Day Low Price price point at Wal-Mart or Sam’s Club locations (if included in the network). Discount off remaining balance does not apply at Wal-mart or Sam’s Club locations.
Non-Network — Reimbursed up to $70
Premium Plan
Network — Up to $175 retail allowance and 20% discount off remaining balance

Up to $77 Every Day Low Price price point at Wal-Mart or Sam’s Club locations (if included in the network). Discount off remaining balance does not apply at Wal-mart or Sam’s Club locations.
Non-Network — Reimbursed up to $70
Contact Lenses — once every calendar year in place of eye glass lenses Contact Lenses — once every calendar year in place of eye glass lenses
Elective 1
If member prefers contacts to glasses

Retail allowances may be used over multiple visits in the same calendar year.
Basic Plan
Network — Up to $125 retail allowance and 15% discount off conventional or 10% discount off disposable remaining balance

Up to $92 Every Day Low Price price point for contact lenses at Wal-Mart or Sam’s Club locations (if included in the network). Discount off remaining balance does not apply at Wal-mart or Sam’s Club locations.
Non-Network — Contact lenses reimbursed up to $105
Premium Plan
Network — Up to $175 retail allowance and 15% discount off conventional or 10% discount off disposable remaining balance

Up to $129 Every Day Low Price price point for contact lenses at Wal-Mart or Sam’s Club locations (if included in the network). Discount off remaining balance does not apply at Wal-mart or Sam’s Club locations.
Non-Network — Contact lenses reimbursed up to $105
Necessary
If medically necessary with prior approval from National Vision Administrators, L.L.C. (NVA)
Network — Additional costs covered at 100% Non-Network — Contact lenses reimbursed up to $210
Fitting and Evaluation Network — $20 copayment for daily contact lenses;
$30 copayment for extended contact lenses;
$50 copayment for specialty contact lenses
Non-Network — Reimbursed up to $20 for daily contact lenses;
$30 copayment for extended or specialty contact lenses
Other Other
Optional Items (cosmetic extras) Network — Discount applied to all lens options Non-Network — Not covered
EyeEssential Discount Plan Network — When members exhaust their annual benefits, NVA offers the EyeEssential Discount Plan, which provides significant discounts on materials through participating NVA network providers. Non-Network — Not covered
LASIK Discounts Network — NVA members will pay a maximum amount for corrective laser surgery:
  • Traditional PRK – $1,500 per eye
  • Traditional LASIK – $1,800 per eye
  • Custom LASIK – $2,300 per eye
Members may receive additional benefits at LasikPlus locations nationwide:
  • Special pricing on select technologies
  • Free initial consultation and comprehensive LASIK vision exam
  • Advanced laser technologies including Wavefront and IntraLase (All-Laser LASIK)
  • Financing options available
Non-Network — Not covered
  1. Wal-Mart and Sam’s Club Example: A member with the Premium Plan chooses a pair of frames at Wal-Mart that cost $128. The Premium Plan pays $77, and the member pays the $51 difference.

How the Vision Plan Works

  1. The member may visit a network or non-network provider.
  2. If using a network provider, the member will pay a vision exam copayment plus the applicable cost for materials purchased.
    1. Most lenses and contact lenses have a copayment.
    2. Members needing frames or elective contact lenses will receive a retail allowance. This allowance varies between the Basic and Premium Vision Plans.
    3. See the Benefit Chart for more information.
  3. If using a non-network provider, the member will be responsible for paying the provider in full, as well as submitting a claim form to NVA. NVA will then reimburse the member up to specific amount. This amount is based on the member’s vision plan (Basic or Premium) as well as the service and/or materials purchased. See the Benefit Chart for more information.
  4. Cost maximums are available to members needing corrective laser surgery through NVA’s LASIK discount program.
  5. When a member exhausts their annual benefits, they may still receive significant discounts on materials through NVA’s EyeEssential Discount Plan.
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