Vision and LASIK



You are automatically enrolled in the vision plan when you enroll in one of the dental plans. Your vision benefits are straightforward and easy to understand, so you know exactly what is covered.

Plan A+ also includes LASIK benefits. Plan A and Plan B offer LASIK discounts through the EyeMed vision network.

Who Can Enroll? All employees participating in any of the group dental insurance plans (Plan A+, Plan A, Plan B) receive the vision benefit at no additional cost. The benefit pays specified expenses for frames and lenses, or for contact lenses, for the employee and his or her eligible dependents.

An employee must enroll in the group dental insurance plan to receive the vision benefit.
 

Vision Perfect® Plan Summary  
Maximum Benefit (per calendar year) $150
Annual Eye Exam N/A
Lenses (per pair)  
-Single Subject to Maximum
-Bifocal Subject to Maximum
-Trifocal Subject to Maximum
-Lenticular Subject to Maximum
Contact Lenses - elective/medically necessary Subject to Maximum
Frames Subject to Maximum

 

EyeMed Discount Overlay (Additional discounts only if seen by an EyeMed participating provider.)
Exam (with dilation as necessary) $5 off routine exam
$10 off contact lens exam
Standard Plastic Lenses  
-Single $50
-Bifocal $70
-Trifocal $105
-Frame 35% off retail price with a complete pair of glasses (Items purchased separately - 20% off retail price)
Standard Progressive Lenses $65 + Standard Plastic Lens Cost
Premium Progressive Lenses 20% discount
Standard Polycarbonate $40
Tint (Solid and Gradient) $15
Scratch Resistant Coating $15
Anti-Reflective Coating $45
Ultraviolet Coating $15
Other Add-Ons 20% discount
Contact Lenses - Conventional 15% off retail price (does not apply to fitting). After initial purchase, replacements by mail are offered at substantial savings via eyemedvisioncare.com

Based on applicable laws, reduced costs may vary by doctor location.

Ameritas of New York provides each employee with a Certificate of Insurance explaining the plan benefits and limitations in complete detail. For answers to your claims questions, call 1-800-659-5556. The vision claim form NY is available in the quick links to the right.

1. Schedule an appointment with any vision care provider that you choose.

2. If you are visiting an EyeMed network provider, make sure the provider looks at both sides of your ID card. The front shows that Vision Perfect is the insurance plan, and the back shows that you are eligible for the EyeMed network discounts. Be sure to reference code 9232372.

3. After your discounts have been applied, pay the provider and submit a claim form with your receipts to Ameritas Life Insurance Corp. of New York Claims Office, P.O. Box 82535, Lincoln, NE 68501. We will reimburse your covered materials expenses up to $150.

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LASIK: Plan A+ includes LASIK benefits. LASIK Advantage is not tied to a network. You can seek services from any doctor at any facility.

Covered Procedures: Your LASIK Advantage benefits can be applied to the following procedures: LASIK, LASIK with IntraLase or “All laser LASIK”, LASIK with wavefront technology, PRK, LASEK, and ASA.

Increasing Benefits: The plan benefit is $350 per eye for year 1 and year 2, and increases to $700 in year 3. Your per eye benefit amount increases over time, and cannot be combined toward double coverage for a single eye. If you wait to have your eye surgery until the third year that you are on the plan, you will receive a greater benefit.

Lifetime Benefits Per Eye: These are lifetime benefits. Although the benefit amount increases over time, the payment is available only once per person, per eye instead of per benefit year

Age Requirement: Members must be age 18 or older to receive LASIK benefits.

This information does not indicate these procedures are appropriate for every condition or patient. Individuals age 18 and older who are interested in laser vision correction surgery should consult their eye doctor to determine whether they are candidates or not. The eye doctor or laser correction provider should explain all procedure options available, including the potential risks and side effects of each.

Plan A and Plan B offer LASIK discounts through the EyeMed Network. Discounts include 15% off LASIK or PRK procedures, or 5% off a promotional price.

You can visit the vision provider of your choice. Plus, you can get additional savings through the EyeMed Network. 97% of EyeMed members choose the convenience and value of visiting a network provider. Find an EyeMed provider.

 

 


What if my Provider is Not in the EyeMed Network? That's ok, you may visit any vision provider you choose. Select as many pairs of prescription glasses and contacts as you want and pay the provider at the time of services. Ask the provider to complete an Ameritas vision claim form (NY). Submit the form, along with a copy of an itemized bill from your provider, to Ameritas Life Insurance Corp of New York for reimbursement.

Proof of Loss: Written proof of loss must be given to us within 120 days after the incurred date of the services provided for which benefits are payable. If it is impossible to give written proof within the 120-day period, we will not reduce or deny a claim for this reason if the proof is filed as soon as reasonably possible.


Based on applicable laws, reduced costs may vary by doctor location.

group@ameritas.com 800-659-5556 Monday-Thursday 8am to 1am and Friday 8am to 7:30pm (ET)

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