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How the Select Advantage Discount Plan Works
The Avesis Vision Discount plan provides vision discounts rather than insured
benefits, making it worry-free, hassle-free and paper-free. There are no
claim forms for the Participant to file, no waiting periods, prior authorizations
or insurance provisions.
Avesis substitutes a single, attractive identification card for paperwork, claim
forms and provider directories that can become out of date. On the back of each
card is a toll free number that puts Participants in touch with trained, professional
customer service representatives who provide current information about the locations
of Avesis providers and answer questions about the program.
When scheduling an appointment, Participants should identify themselves as Avesis
cardholders. To receive the Avesis negotiated discounts, a membership identification
card must be presented at the time of service.
Avesis guarantees...
the lowest retail price on eyeglasses for 30 days from the date of purchase or the
difference will be refunded.
Avesis guarantees...
eyeglass frame and lens quality against manufacturer's defects or flaws in workmanship
for one full year or the eyewear will be replaced.
Avesis guarantees...
unrestricted frame and lens selection, including designer, fashion and traditional frames;
and prescription or non-prescription sunglasses.
Avesis guarantees...
unlimited eye care and eyewear purchases for enrollees, spouses and dependent children
under the age of 25.
Examinations
The charge to the Participant is 20% less than the provider's documented usual and
customary fee with a negotiated cap to ensure that the Participants receive the best price.
There are no provisions for discounts on eye examinations performed by non-network providers.
Frames
Frame selection from network providers is unlimited. Traditional, fashion and even designer styles
are available at discounts according to fixed formulas. Because retail prices for frames may be as
much as wholesale plus 300%, the unique Avesis pricing formula represents substantial savings.
Lenses
Eyeglass lens purchases are unrestricted and unlimited. Network providers guarantee the
accurate filling of all prescriptions as written - their own as well as those of providers who
are not Participants of the network. Virtually all types of lenses, from traditional glass to
space age polycarbonate are available at fixed, discounted fees. Options such as tints, gradients,
photogray and UV 400 (filters ultraviolet light) are also available at fixed, discounted fees.
Contact Lenses
Premium contact lenses, comprehensive contact lens care and complete contact lens supplies -
from solutions to replacement lenses - are available at fixed, discounted fees. The Avesis contact
lens program provides unlimited follow-up care and visits for 12 months after the initial fitting.
If, within 45 days, the prognosis for a successful contact lens fitting is unsatisfactory to the
patient and the doctor, 50% of the total fees, excluding the examination, will be returned to the
patient.
Schedule of Benefits
| Benefit Frequency |
| |
In-Network |
Out-of-Network |
| Vision Examination |
Unlimited |
N/A |
| Standard Lenses (pair) |
Unlimited |
N/A |
| Frame |
Unlimited |
N/A |
| Contact Lenses |
Unlimited |
N/A |
| Benefit Allowance and Reimbursement |
| |
In-Network |
Out-of-Network |
| Vision Examination |
Members will pay no more than $45 |
N/A |
| Standard Lenses - Single Vision |
Member will pay no more than $35 |
N/A |
| Standard Lenses - Bifocal |
Member will pay no more than $50 |
N/A |
| Standard Lenses - Trifocal |
Member will pay no more than $65 |
N/A |
| Frame |
Save 20% - 50% off the retail fees |
N/A |
| Contact Lenses |
Save 5% - 20% off the retail fees |
N/A |
| Non-Standard Lenses |
20% off the providers retail fees |
N/A |
| Tints, Scratch Coating, etc. |
20% off the providers retail fees |
N/A |
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