Active Lifestyle Vision
Adding vision coverage to your Medicare Supplement plan is incredibly easy. Our Active Lifestyle vision coverage – administered by VSP Vision Care – can be bundled with our dental coverage to complete your benefit package.
Our partnership with VSP provides:
- The largest national network of independent eye doctors.
- Vision care from the best doctors – doctors within the VSP network have met the highest credential requirements.
- Large selection of eyewear, from classic styles to trendy frames, to fit you, your family, and your style.
- Combined billing for hassle-free benefits that are easy to understand.
- Access to world-class certified customer service team and benefit information 24/7
| Plan Pays | Copay | Frequency |
WellVision Exam | ||
| Focuses on eyes and overall wellness | $10 | Annual |
Prescription Glasses and Lenses | ||
| Frames $150 allowance; 20 percent savings on amount over allowance | $25 | Annual |
| Lenses Single, lined bifocal and trifocal, polycarbonate for dependent children | $25 | Annual |
| Contacts (instead of glasses) $150 allowance; copay does not apply, contact lens exam (evaluation and fitting) | $25 | Annual |
NOTE: That the Vision benefit overview represents coverage for In-Network doctors ONLY. For Out-Of-Network information please contact your local sales representative.
NOTES: These summaries are samples of benefits. Policies have exclusions and limitations that may limit coverage. For complete coverage details, please refer to your policy, VINV-100A-[2016]-(state specific abbreviation, if applicable).
EXCLUSIONS: There are no Benefits for professional services or materials connected with: • Orthoptics or vision training and any associated supplemental testing. • Plano lenses (less than a ± .50 diopter power). • Two pair of glasses in lieu of bifocals. • Replacement of lenses and frames furnished under this policy that are lost or broken, except at the normal intervals when services are otherwise available. • Medical or surgical treatment of the eyes. • Necessary Contact Lenses • Corrective vision treatment of an Experimental Nature. • Costs for services and/or materials above stated allowances. • Services and/or materials not indicated in the Policy or Summary of Vision Plan Benefits as covered services. • Refitting of contact lenses after the initial (90-day) fitting period. • Contact lens insurance policies or service agreements. • Additional office visits associated with contact lens pathology. • Services associated with CRT or Orthokeratology. • Contact lens modification, polishing or cleaning • Local, state and/or federal taxes, except where Renaissance or its claims administrator is required by law to pay. • Replacement of lost or damaged contact lenses, except at the normal intervals when services are otherwise available.
LIMITATIONS: Coverage for services may be limited based on the age of the person receiving the services; coverage for certain services may be limited to a maximum number of occurrences during a specified time period (such as two times per year or one time every three years).
The premium rate will vary between plans. The policy has a term of one year and will automatically renew (upon payment of required premium) unless terminated in accordance with the policy provisions. Coverage may be terminated for reasons stated in the policy. Coverage ceases upon termination of the policy. Products and services referred to herein may not be available in all states or jurisdictions.
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