Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Avera Health Plans and VSP provide Vision Coverage for Children
Document related concepts
Transcript
Visit vsp.com for more details on your child’s vision benefit and the exclusive savings and promotions for VSP members. Avera Health Plans and VSP provide Vision Coverage for Children Your child is covered-in-full for an eye exam and glasses or contacts every year. Contact us. vsp.com | 1-800-877-7195 Your child’s eyes deserve the best care to keep them healthy year after year. Plus, with VSP, you’ll get a great value on eye care and eyewear for your child. You’ll like what you see with VSP. • Find a VSP doctor who’s right for your child. To find a VSP doctor, visit vsp.com. • Review your child’s benefit information. Visit vsp.com to review your child’s plan coverage before an appointment. • At the appointment, tell them your child has VSP. That’s it! We’ll handle the rest — there are no claim forms to complete when your child sees a VSP doctor. Eye Exams for Children Eighty percent of what we learn is through our eyes.* Many states require that children get a comprehensive eye exam before kindergarten. Schedule an eye exam for your child at the beginning of every school year and start the year off right. Visit vsp.com to find a VSP doctor who specializes in child eye care. Source: Ritty et al (1993) [Ritty M.J., Solan H.K., Cool S.J. Visual and sensory-motor function in the classroom in a primary report of ergonomic demands., J.Am. Optom. Assoc. 1993, 64-238-244] * Vision Benefit Summary Taking care of your child’s eyes with VSP includes a covered-in-full benefit outlined below. You will have access to the highest quality vision care from a VSP doctor you can trust. Visit vsp.com to find a doctor who’s right for your child and one who carries children’s frames from our exclusive Otis & Piper™ Eyewear Collection. VSP Doctor Network: VSP Choice BENEFIT DESCRIPTION CO-PAY (Your cost) FREQUENCY Your coverage with a VSP Advantage Doctor A thorough eye exam that tests for childhood eye health and vision issues, like nearsightedness, amblyopia (lazy eye), and strabismus. $0 Every 12 months Frames Frames covered in full from our exclusive Otis & Piper Eyewear Collection $0 Every 12 months Lenses • Single vision, lined bifocal, lined trifocal or lenticular lenses • Polycarbonate, scratch-resistant coating and UV protection $0 Included in Prescription Glasses Every 12 months Lens Options 20 – 25 percent off other lens options N/A Every 12 months Contact lens exam and minimum three-month’s supply of contact lenses are covered in full. Ask your VSP doctor which contacts qualify for your child’s plan $0 Every 12 months WellVision Exam® Prescription glasses Contacts (Instead of glasses) Glasses and Sunglasses Extra Savings and Discounts • 20 percent off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last WellVision Exam Laser Vision Correction • Average 15 percent off the regular price or 5 percent off the promotional price; discounts only available from contracted facilities VSP guarantees coverage for VSP doctors only. Coverage information is subject to change. Once your child’s benefit is effective, visit vsp.com for details. Coverage information is subject to change. In the event of a conflict between this information and the applicable contract, the terms of the contract will prevail. ©2013 Vision Service Plan. All rights reserved. VSP and WellVision Exam are registered trademarks of Vision Service Plan. All other company names and brands are trademarks or registered trademarks of their respective owners. Discrimination is Against the Law Avera Health Plans complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Avera Health Plans does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Avera Health Plans: Provides free aids and services to people with disabilities to x communicate effectively with us, such as: Qualified qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). Provides free language services to people whose primary x language is not English, such as: qualified interpreters and information written in other languages. You can file a grievance in person or by mail, fax, or email. You may also contact the Complaint and Appeals Coordinator if you need assistance with filing a complaint. If you need these services, contact the Avera Health Plans Service Center at 1-888-322-2115, (TTY 711), 8 a.m. to 5 p.m. CST, Monday through Friday. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or call 1-800-368-1019 or 1-800-537-7697 (TDD). Or mail: US Department of Health and Human Services, 200 Independence Avenue SW Room 509F, HHH Building, Washington, D.C. 20201 If you believe that Avera Health Plans has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with: Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. Complaint and Appeals Coordinator Avera Health Plans 3816 S. Elmwood, Suite 100, Sioux Falls, SD 57105-6538 Fax 1-800-269-8561 Email [email protected] Getting Help in other Languages Language assistance services are available free of charge. Our Service Center is available 8 a.m. to 5 p.m. CST, Monday – Friday, toll-free at 1-888-322-2115 (TTY: 1-800-877-1113). x ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-322-2115 (TTY: 1-800-877-1113). x 86&((9<RJWLDVNRMKDLVOXVHmoobFRYNHYSDEW[RJOXVPXDMNHYSDEGDZEUDXNRM+XUDX-888-322-2115(TTY: 1-800-877-1113). x CHÚ Ý: Nұu bҢn nói Tiұng Viҵt, có các dҷch vӅ hҽ trӄ ngôn ngӋ miҴn phí dành cho bҢn. GҸi sҺ 1-888-322-2115 (TTY: 1-800-877-1113). x XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-888-322-2115 (TTY: 1-800-877-1113). x ὀព㸸ዴᯝᝍ⏝⦾㧓୰ᩥ㸪ᝍྍ௨ච㈝⋓ᚓㄒゝຓ᭹ົࠋㄳ⮴㟁1-888-322-2115 (TTY: 1-800-877-1113). x ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-322-2115 (TTY: 1-800-877-1113). x ʦʻʰʺʤʻʰʫ͗ ȿɫɥɢɜɵɝɨɜɨɪɢɬɟɧɚɪɭɫɫɤɨɦɹɡɵɤɟɬɨɜɚɦɞɨɫɬɭɩɧɵɛɟɫɩɥɚɬɧɵɟɭɫɥɭɝɢɩɟɪɟɜɨɞɚɁɜɨɧɢɬɟ1-888-322-2115 ɬɟɥɟɬɚɣɩ (TTY: 1-800-877-1113). 800-877-11131 ϢϜΒϟϭϢμϟϒΗΎϫϢϗέ888-322-2115ϢϗήΑϞμΗϥΎΠϤϟΎΑϚϟήϓϮΘΗΔϳϮϐϠϟΓΪϋΎδϤϟΕΎϣΪΧϥΈϓˬΔϐϠϟήϛΫΙΪΤΘΗΖϨϛΫ· ΔυϮΤϠϣ x x ࢺ࢜ࢭ࢛࢘ࢿࢭࢥࢾࢭ࢙ࢾࢭ࢚ࢸࢥࢵࢿࢭ࢟ࢭࢦࢭࢤࢭࢥ, ࢭ࢚࢛ࣃࢤࢯࢭ࢚ࢾࢥࢸࢧࢶࢲࢨࢿࢭ࢚࢟ࢭࢦࢭࢺ࢛ࣃࢾࢸࢦࢬࢷࢾࢭࢹࢡࢾ࢚ࢡࢰ࢟ࢿࢨࢡࢻࢧࢿ࢙ࢾࢭ࢚ ࢺ࢙ࢣ1-888-322-2115 (TTY: 1-800-877-1113). 1-888-322-2115 (TTY: 1-800-877-1113). x ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-322-2115 (TTY: 1-800-877-1113). x 㨰㢌: 䚐ạ㛨⪰ ㇠㟝䚌㐐⏈ ᷱ㟤, 㛬㛨 㫴㠄 ㉐⽸㏘⪰ ⱨ⨀⦐ 㢨㟝䚌㐘 ㍌ 㢼㏩⏼␘. 1-888-322-2115 (TTY: 1-800-877-1113) ⶼ㡰⦐ 㤸䞈䚨 㨰㐡㐐㝘. x 8n·>: Õô,p LL 0 Õp0õ 0ßn á0ñqxŃ [Ģ Øùʽp kÅ÷ìkºŁ ·Ü k¼ DČ0 Úܼ 1-888-322-2115 (8p k6s¼: 1-800-877-1113) x Ks:adE:͗ŬŽŐŽǀŽƌŝƚĞƐƌƉƐŬŽ-ŚƌǀĂƚƐŬŝ͕ƵƐůƵŐĞũĞnjŝēŬĞƉŽŵŽđŝĚŽƐƚƵƉŶĞƐƵǀĂŵďĞƐƉůĂƚŶŽ͘EĂnjŽǀŝƚĞ1-888-322-2115 (TTY- Telefon za osobĞƐĂŽƓƚĞđĞŶŝŵ govorom ili sluhom: 1-800-877-1113) x ƅŞŻȽŅŚɉ ȒŞȋơǯřēƴŚ éřǯžŻ ŴƤȓîŷ Ƅ, ȒơƑĐșřȇŻȓŧŚ éŴƤȒīŻŶǯřóǯŅĕś ȉƉóǽƷĆŹřơșƇŞȥŞșȒ Ƅ ǶƴŚ éɇĆȄ ƄŏȄ ƄơȽŬŐ 1-888-322-2115 (TTY: 1-800-877-1113)ɇ Form 0017-30 PS (Rev. 2/17)
