Are there co-payments with CVC?
Like all other insurance plans, CVC requires minimal co-payments. The co-payment for the yearly well-eye examination is $10.00 for each exam. The co-payment amount for glasses is $15.00. There is no co-pay required for contact lenses

What is the frame limit?
Community Vision Care establishes frame coverage so that a patient may choose frames which will be covered at 100% after a co-payment of $15.00. The patient also has the option of choosing a frame that exceeds the plan limit and paying the cost of the upgrade. The plan allowance is typically between $90.00 and $120.00 (price varies by provider).

What is the maximum coverage for contacts?
There is a $105.00 maximum per year for contacts which are visually necessary and $165.00 for contacts which are medically necessary.

Can I purchase contacts and eyeglasses at the same time?
The plan covers either contacts or glasses within a 12-month period. For example, covered services rendered on June 1 would be eligible again after June 1 the following year. A patient may receive benefits toward glasses in one year and contacts the following 12 months, and vice versa.

What is the difference between visually necessary contact lens coverage and medically necessary coverage?
Visually necessary contact lenses are prescribed to correct common vision problems such as near sightedness, far sightedness or astigmatism. Medically necessary contact lenses are required when a member has Keratoconus, a disease of the cornea, or Aphakia.

If I have a well-eye exam, am I eligible for a contact lens fitting within the same year?
Yes, a contact lens fitting is included in the allowance when new contact lenses are purchased.

Will the plan cover a referral exam for a medical problem with my eyes?
The Community Vision Care plan covers one well-eye exam in a 12-month period. If a patient requires a referral for medical vision care, charges should be submitted under the patient’s major health insurance plan.

What is the definition of a dependent child?
Community Vision Care defines a dependent child as one who is unmarried and under age 19, or under 23 years of age and enrolled as a full-time student, who lives full-time with the enrolled parent.

Who is covered by “single + 1” coverage?
This option is intended for married couples but also can apply to a parent and one dependent child (as defined above). This coverage does not extend to nonfamily members or family members other than a dependent child.

How does the plan coordinate benefits with other vision plans?
Coordination of benefits is determined by the “birthday rule” when dependents are enrolled in more than one vision plan. The employee is always primary under the employer’s plan, but dependent children will have primary coverage under the plan of the parent whose birthday occurs first in the calendar year. CVC will reimburse out-of-pocket charges remaining after the primary plan has paid benefits to the extent that they are covered under CVC’s schedule of benefits.

How often can I change my enrollment?
Enrollment in CVC is for a 24-month period provided your employment or family status does not change. If you have a family status change, you may modify your enrollment in a manner which is consistent with those changes (i.e. birth or adoption of a child, marriage or divorce, child who is no longer a full-time student).

What if I decide to terminate the plan or am no longer affiliated with my current employer?
All plan members are financially committed to make contributions to CVC for a period of 24 months starting from the effective date of coverage as confirmed by the member’s signature on the CVC enrollment form. The plan ends upon termination of employment.

Who can I call if I have any additional questions or concerns?
Most questions or concerns can be quickly resolved by calling Customer Service at 1-800-386-8606.