Vision Plan Benefits for The University of Texas System You may choose from two plans: Superior Basic Plan, or Superior Plus Plan Benefits through Superior National Network
Superior Basic Plan
Superior Plus Plan
Co-Pays
Co-Pays
Exam Materials1 Contact Lens Fitting
$35 $0 $35
Monthly Premiums Emp. only Emp. + spouse Emp. + child(ren) Emp. + family
Benefits
In-Network
$35 $0 $35
Monthly Premiums $5.02 $7.90 $8.10 $12.84
Services/Frequency Exam Frames Contact Lens Fitting Lenses Contact Lenses
Exam Materials1 Contact Lens Fitting Emp. only Emp. + spouse Emp. + child(ren) Emp. + family
$7.64 $11.98 $12.82 $18.10
Services/Frequency 1 per plan year 1 per plan year 1 per plan year 1 pair per plan year 1 allowance per plan year
Out-of-Network
Exam Frames Contact Lens Fitting Lenses Contact Lenses
In-Network
1 per plan year 1 per plan year 1 per plan year 1 pair per plan year 1 allowance per plan year
Out-of-Network
Exam (MD) Covered in full Up to $42 Covered in full Up to $42 Exam (OD) Covered in full Up to $42 Covered in full Up to $42 Frames $140 retail allowance Up to $53 $165 retail allowance Up to $81 Contact Lens Fitting (standard2) Covered in full Not covered Covered in full Not covered Contact Lens Fitting (specialty2) $50 retail allowance Not covered $50 retail allowance Not covered Lenses (standard) per pair Single Vision Covered in full Up to $32 Covered in full Up to $32 Bifocal Covered in full Up to $46 Covered in full Up to $46 Trifocal Covered in full Up to $61 Covered in full Up to $61 Polycarbonate for dependent children Not covered Not covered Covered in full Not covered only (up to age 25) Scratch coat (factory) Not covered Not covered Covered in full Not covered Ultraviolet coat Not covered Not covered Covered in full Not covered Progressive lens See description3 Up to $61 $120 retail allowance4 Up to $61 Contact Lenses5 $125 retail allowance Up to $100 $150 retail allowance Up to $100 After co-pays. Co-pays apply to in-network benefits only. 1 Materials co-pay applies to lenses and frames only, not contact lenses. 2 Specialty contact lens fitting fee applies to new contact wearers and/or a member who wear toric, gas permeable, or multifocal lenses. 3 Covered at the provider’s in-office retail price for a standard lined trifocal; member pays difference between the progressive and the trifocal minus a 20% discount on the overage. Applicable co-pay applies 4 Overages on standard progressive lenses will be the member’s responsibility 5 Contact lenses are in lieu of eyeglass lenses and frames benefit.
superiorvision.com (844) 549-2603
Superior Vision Services, Inc. P.O. Box 967 Rancho Cordova, CA 95741 (844) 549-2603 superiorvision.com/ut The Superior Vision Plan is underwritten by National Guardian Life Insurance Company. National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, AKA The Guardian or Guardian Life NVIGRP 5-07 0321-BSv2/TX
Vision care plan administator for
Benefits that go above and beyond
Some eye care professionals may offer additional discounts. Ask your eye care professional if they offer Superior Vision discounts, as not all locations participate.
Additionally, please be sure to verify that the services and discounts are available prior to scheduling or receiving service, as offers may vary. Here are some possible discounts offered through the Superior Vision plan: Discounts on covered materials1 • Frames: 20% off amount over allowance • Lens options: 20% off retail • Conventional contacts: 20% off amount over allowance • Disposable contacts: 10% off amount over allowance
Discounts on non-covered exams, services, and materials1 • Exams, frames, and Rx lenses: 30% off retail • Lens options, contacts, miscellaneous options: 20% off retail • Disposable contact lenses: 10% off retail • Retinal imaging: $39 maximum out of pocket
Maximum member out-of-pocket costs1 The following options have out-of-pocket maximums on standard (not premium, brand, progressive, or otherwise upgraded) lenses. Discounts and maximums may vary by lens type, so please check with your eye care professional.
Scratch coat Ultraviolet coat Tints, solid Tints, gradient Polycarbonate Blue light filtering Digital single vision
Member out-of-pocket1 $15 $12 $15 $18 $40 $15 $30
Member out-of-pocket1
Progressive lenses
Standard / Premium / Ultra / Ultimate
Anti-reflective coating
Standard / Premium / Ultra / Ultimate
Polarized lenses Plastic photochromic lenses High index (1.67 / 1.74)
$55 / $110 / $150 / $225 $50 / $70 / $85 / $120 $75 $80 $80 / $120
Hearing discounts1 A National Hearing Network of hearing care professionals, featuring Your Hearing Network, offers Superior Vision members discounts on services, hearing aids and accessories. These discounts should be verified prior to service
The Plan discount features are not insurance. All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances, minus available discounts. These are not covered by the plan. Discounts are subject to change without notice. 1 Not all providers participate in Superior Vision Discounts, including the member out-of-pocket features. Call your provider prior to scheduling an appointment to confirm if he/she offers the discount and member out-of-pocket features. The discount and member out-of-pocket features are not insurance. Discounts and member out-of-pocket are subject to change without notice and do not apply if prohibited by the manufacturer. Lens options may not be available from all Superior Vision providers/all locations.
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(844) 549-2603
SVS-MKG20-0080v001 PDF 03/2020
Laser vision correction (LASIK)1 A National LASIK Network of laser vision correction providers, featuring QualSight, offers Superior Vision members a discount on services. These discounts should be verified prior to service.
Vision care plan administator for
Be ‘in the know’ before your eye exam The importance of an eye exam Have you made time for a visit to an eye care professional this year? Good vision is more than just corrective eyewear (although 150 million Americans use corrective eyewear of some kind).1 An estimated 80% of the information our brains receive comes through our eyes.2 And a comprehensive eye exam can even help diagnose a number of health conditions early, including conditions like diabetes, cataracts, high blood pressure, high cholesterol, and macular degeneration.3 Questions to ask your eye doctor When visiting with any health professional, it never hurts to be prepared. Here are some questions to consider asking your eye doctor: E
F P
T O Z
What is my visual acuity? (Example: 20/20 vision) Should I have my eyes dilated?
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Are there more cost-effective treatment options available? Overall, how healthy are my eyes?
American Optometric Association 2016. Concord Eyecare. http://concordeyecare.com.au/concord-eye-care-services/behavioural-optometry/. Accessed June 6, 2019. 3 https://www2.versanthealth.com/medicaladvantagewhitepaper. Accessed December 30, 2019. 1 2
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(844) 549-2603
SVS-MKG20-0632v001 PDF 03/2020
Am I at risk of developing an eye disease?
What are the best correction options for my eyes?
Find an in-network eye care professional
It’s easy to find an in-network eye care professional. Follow the simple instructions below to get started.
Here’s how to find an eye care professional near you 1. 2. 3. 4. 5. 6.
Visit superiorvision.com and click “Find an eye care professional.” Enter your location information. Select the “Insurance Through Your Employer” option. Pick your plan’s network from the drop-down list. Choose your desired distance. Select the “Search” button.
Not sure what your network’s called? If you are not sure of the name of your network, select the “I Don’t Know” option from the list to view our helpful chart. You may also log into the member area to view eye care professionals that are specific to your network.
Want to narrow your search results? Once you’re at the search results page, you can refine the results by the name of the eye care professional, the name of the practice or the services that are offered.
Once you’ve selected an in-network eye care professional, call them to verify network participation, services and acceptance of your vision plan. Not all eye care professionals at each office or optical store are considered in-network eye care professionals, nor do they participate in all networks.
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1 (800) 507-3800
superiorvision.com
SV_FAINP_GEN_062818
I found a eye care professional. Now what?
Shop online with your benefits
Through 1-800 Contacts, Befitting, Glasses.com, and ContactsDirect, you’ll be able to utilize your vision benefits at your convenience from your home or on the go.
1-800 Contacts is one of the most recognized online contact lens retailers in the industry. They have an established reputation for their customer service, backed by an industry-leading Net PromoterScore of 76.
Befitting.com has artificial intelligence-driven tools to find the perfect pair of eyeglasses with personalized, curated recommendations. Shop for single and progressive lenses, prescription sunglasses, and advanced blue light blocking lenses. Free shipping and returns are also included.
Glasses.com is one of the most trusted online stores for popular eyewear brands, including prescription glasses and sunglasses.
With ContactsDirect, Superior Vision members have the same seamless in-network experience when shopping for contact lenses online as they do when shopping in-person.
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superiorvision.com/shop-online 1 (800) 507-3800 1 (800) 507-3800
SV-MKG20-0633v003 PDF 09/2020
Check your benefit details for coverage, plan, and network information.
Creating an account with our mobile app App features
With the free Superior Vision app, members can: • Locate in-network eye care professionals • Review your benefits and the benefits of any dependents • See which benefits you have used and which benefits are currently available • View, print, or email your member ID card
Step 1
Launch the app, and tap on the “Create a new account” button located towards the bottom.
Step 3
Enter your information to verify eligibility and to create your username and password.
We’re here to help!
If you need assistance creating an account, please call 1 (800) 507-3800 or visit superiorvision.com/contact.
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SV-MKG19-0589v001 PDF 11/2019
First, download the “Superior Vision” app, available for Android and iPhone devices.
Step 2
Discreet models to fit every lifestyle.
Receive a $200 mail-inrebate after purchase!* Breakthrough technology opening up the world to you.
Hear better and save more Exclusively for Superior Vision members: • • • •
Save up to 40% on digital hearing aids 4 year limited warranty 4 year FREE battery supply 60-day satisfaction guarantee and a $200 mail-in-rebate on top-rated hearing aids*
Hearing health care services administered by
Visit superiorvision.yourhearing.com or call 1 (888) 494-1272 for more information and to book your free hearing exam. *Limited time offer. Certain restrictions apply. Call for details.
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VH-MKG20-0606v001 PDF 01/20
Schedule your consultation with a local hearing care professional today.