superiorvision.com | 1 (800) 507-3800
Vision Care Plan for Vance Charter School Benefits through Superior National network
Frequency Exam Frame Contact lens fitting Eyeglass lenses Contact Lenses
12 months 24 months 12 months 12 months 12 months
(based on date of service)
Need help? Contact 1 (800) 507-3800 or visit superiorvision.com for assistance. Exams Eye exam copay:
$10
Contact lens fitting2 copay (standard and specialty):
Materials1 Materials copay:
$15
Monthly Premiums
$25
Specialty In-network allowance:
$50
Frames In-network allowance:
$100
Contacts4 in lieu of glasses
Employee only:
$7.46
Employee + 1 dependent:
$14.54
Employee + family:
$21.44
In-network allowance:
$120
Lenses (per pair)
In-Network Coverage
Out-of-Network Reimbursement
Single vision
Covered-in-full
Up to $34
Bifocal
Covered-in-full
Up to $48
Trifocal
Covered-in-full
Up to $64
Progressives
See description3
Up to $64
Polycarbonate for dependent children
Covered in full
Not covered
Shop with convenience while using your benefits through these in-network online retailers.
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