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Vision Insurance Plan

Caring for your eyes is a very important part of your overall health and wellness. That’s why the State offers you competitive vision coverage at affordable rates through Humana Vision (2022 Brochure) ( 2.79 MB). Coverage is available to retirees through COBRA and to COBRA participants if they were enrolled prior to termination. Find out if you are eligible for these benefits.

 

Exam and Materials (Plan 3004)
Monthly Member Rates

Employee Only

$6.96

Employee + Spouse

$13.74

Employee + Children

$13.60

Family

$21.36

Frequency (based on the date of service)

Exam Every

12 months

Lenses Every

12 months1

Frames Every

24 months

Co-payments

Exam

$10.00

Lenses and/or Frames

$10.00

Benefits
Network
Out-of-Network
Eye Exam

100% after co-pay

$40 allowance

Lenses1

  Single

100% after co-pay

$40 allowance

  Bifocal

100% after co-pay

$60 allowance

  Trifocal

100% after co-pay

$80 allowance

  Frames

$75 wholesale

$60 retail

Contact Lenses2

   Elective3

$150 allowance

$75 allowance

   Medically Necessary4

100%

$100 allowance

Lasik

We have contracted with many well-known facilities and eye doctors to offer Lasik procedures at substantially reduced fees. You can take advantage of these low fees when procedures are done by network providers. Participants receive a 25 percent discount off the usual and customary price or a five percent off advertised promotions or specials for LASIK services provided by in-network providers, whichever discount is greater. The discount includes consultations, laser procedure, follow-up visits and any additional necessary corrective procedures.

Calendar Year Deductible

None, after plan co-payments

Calendar Year Maximum Benefit

Up to plan limits

Lifetime Maximum Benefit

Unlimited

Waiting Periods

None

 

For more detail, visit the Humana Vision Web site.

1 You can purchase either glasses or contact lens. Coverage applies to one or the other.

2 This allowance is paid with the same frequency as lenses, in the place of the lens and frame benefit.

3 The contact lens allowance applies to evaluation and fitting fee, if applicable, and materials. Members may be eligible to receive up to a 15 percent discount on participating provider professional services.

4 Medically necessary (prior authorization required) is defined as 1) following cataract surgery without intraocular lens; 2) correction of extreme visual acuity problems not correctable with glasses; 3) anisometropia greater than 5.00 diopters and asthenopia or diplopia, with spectacles; 4) Keratoconus; or 5) monocular aphakia and/or binocular aphakia where the doctor certifies contact lenses are medically necessary for safety and rehabilitation to a productive life.