Vision Benefit
All Peoples Health plans offer a vision benefit for medical vision care, as well as a routine vision care benefit that includes coverage for routine eye exams and eyewear for vision correction.
What’s the Difference Between Routine Vision Care and Medical Vision Care?
Routine Vision Care
Routine care includes services and tests to check your eyes and keep them healthy. Examples are eye exams to see if you need eyeglasses or contacts.
Medical Vision Care
Medical care includes Medicare-covered exams and services to diagnose and treat diseases and conditions of the eye. Examples are cataract surgery and treatments for eye injuries, as well as an annual glaucoma screening.
Routine Vision Care FAQs
How do I get a prescription?
If you need a routine eye exam or a new prescription for eyeglasses or contacts, visit an optometrist in our provider network. To find a provider, visit your member website or use the Routine Vision Providers search tool. Keep in mind that even though a particular location may be in-network, there could be multiple providers at the location, and some of those providers may not be in-network. Be sure to confirm with the individual provider that they are in the network.
Will I have a copay?
You pay $0 for one routine eye exam each year. Please refer to your plan’s Evidence of Coverage for additional details.
How much will lenses and frames cost?
You are covered for one pair of standard lenses and frames on the time frame set by your plan:
- Lenses: “Standard lenses” are covered in full with every pair of glasses. Standard lenses include single vision, lined bifocal, lined trifocal, lenticular, and Tier I (standard) progressive lenses.
- Frames: Your plan provides an allowance amount* you can use toward your purchase of frames (with standard lenses covered in full) or contact lenses (fitting and evaluation may be an additional cost). Your plan pays up to this amount for covered eyeglasses or contact lenses. You are responsible for any costs after that.
You have the option to upgrade to other progressive lens tiers, add anti-reflective coating or choose high-index lenses for an additional fee.
*Allowance amount varies by plan. See a plan’s Evidence of Coverage for more information on allowance amounts and coverage details.
How much will contacts cost?
Contact lenses are $0. Your plan provides an allowance amount* you can use toward your purchase of eyeglass frames or contact lenses (fitting and evaluation may be an additional cost).
*Allowance amount varies by plan. See a plan’s Evidence of Coverage for more information on allowance amounts and coverage details.
How Do I Find the Right Eye Doctor?
Annual Eye Exam, Eyeglasses or Contacts
To find a doctor for an annual eye exam or to get a prescription for eyeglasses or contacts, use our Routine Vision Providers search.
Medical Issue or Injury
To find a doctor if you have a medical issue or injury to your eyes, use our Doctors and Providers search tool.
Questions about vision coverage?
If you have questions or need help finding a network vision care provider, call the Customer Service phone number on your Peoples Health member ID card.