The Vision Care Plan is designed to encourage you to maintain your vision through regular exams and to help with expenses for prescription glasses and contact lenses. The vision care plan is administered by Mutual of Omaha powered by EyeMed. With this plan, you may use in- or out-of-network providers, but the level of benefit is higher when you receive care from a network provider. A listing of network providers can be found at MutualofOmaha.com/vision or by calling Mutual of Omaha directly at 833-279-4358.
For more information, including plan limitations, exclusions and discounted services; please refer to the Vision Care summary plan description by contacting Human Resources. Your provider will verify eligibility of vision benefits. Visit MutualofOmaha.com/vision for details.
In-Network | Out-of-Network |
|
|---|---|---|
| Copay | Coverage after Copay: | Reimbursement: |
| Basic Eye Exam | $10 Copay | Up to $37 |
| Lenses | ||
| Single Vision | $10 Copay | Up to $32 |
| Bifocal | $10 Copay | Up to $48 |
| Trifocal or Lenticular | $10 Copay | Up to $76 |
| Standard Progressive Lenses (added to bifocal copay) | $65 Copay | Up to $48 |
| Contact Lenses (in lieu of lenses and frames) | ||
| Elective | $150 Allowance + 15% off cost over allowance | Up to $120 |
| Frames | ||
| Frames | $150 Allowance + 20% off cost over allowance | Up to $66 |
| Benefit Frequency | ||
| Eye Exam | Every 12 Months | |
| Lenses | Every 12 Months | |
| Frames | Every 12 Months |
|
Benefit Frequency is based on last date of service