Member Frequently Asked Questions
Your Superior Vision benefits information is located in your enrollment materials and can also be found by logging in to the secure member area of our website.
These frequently asked questions address some of the specific features of our vision benefits plans. If you have additional questions, please contact Customer Service at 800-507-3800.
- What is the difference between an in-network provider and out-of-network provider?
- How do I know which services are offered by the in-network providers?
- Nominate a provider to join our network
- What do I do if there are no in-network providers close to me?
- Can I get my eye examination at one location and the materials at another?
How to Use Your Benefits
- What is my plan coverage? How can I use my benefits?
- ID Cards:
- Who receives one?
- How to order or print additional copies?
- How do I use my benefits and get reimbursed when using an out-of-network provider?
Contact Lens Benefits
- What is a Contact Lens Fitting exam?
- How can I use my elective (cosmetic) contact lens allowance?
- What are non-elective (medically necessary) contact lenses?
Frame & Lens Benefits
- What discounts features are available?
- How often can I use my discounts?
- Do I need to show my ID card to the provider to use the discounts?
- Are there any limitations on the frame selection when using the discounts?
- Can I utilize in-store specials, promotions, or coupons along with my Superior Vision plan benefit?
What is the difference between an in-network provider and an out-of-network provider?
We have "in-network" providers (those with whom we have a contract) and "out-of-network" providers (no contract). This means that you can obtain products or services through any provider you choose, though you'll generally pay less with our in-network providers. When visiting an in-network provider, you are responsible for paying any applicable co-pay as well as for items that are not covered or that exceed your benefit limitations. When visiting out-of-network providers, you pay for all services in full, and then you can send in your receipts to Superior Vision for reimbursement according to your out-of-network benefits schedule.
How do I know which services are offered by the in-network providers?
All in-network providers are listed in our directory with the specific services for which they have contracted. This includes an exam, glasses, contacts, Contact Lens Fitting exam, etc.
Nominate a provider to join our network.
If you would like to nominate a provider to join our network, you may submit a Provider Nomination Form.
What do I do if there are no in-network providers close to me?
If there are no in-network providers near you, there are two options:
- Select an out-of-network provider and use your out-of-network benefits, or
- Nominate a provider in your area to the Superior Vision Plan Provider network
Can I get my eye examination at one location and the materials at another?
Yes, you can. Our vision plans allow you the flexibility to choose where you receive services and purchase your materials. Remember to confirm that the providers are in-network to maximize your benefits.
How to Use Your Benefits
What is my plan coverage? How can I use my benefits?
Your exam, lens, and frame benefits vary based on your plan type. Login to the secure member area of our website to view information about your benefits, including eligibility, verification of covered dependents, plan frequency, co-pays, allowances, and information on your previous date of service. If there is a co-pay that is applicable to your benefit plan, it will be noted in the Outline of Benefits schedule in your enrollment materials. All co-payments are paid directly to the in-network provider, or deducted from the out-of-network reimbursement.
You do not need to show an in-network provider your ID card to receive services. However, your ID card includes helpful information and phone numbers for the provider to reference regarding your benefits or discount plan. While you don’t need your card, it is important that you always identify yourself as a Superior Vision member.
Please remember: Your medical health plan and Superior Vision are separate companies; our eye care providers will not accept your medical health insurance plan ID card in place of your Superior Vision ID card.
Will I receive an ID card? Will my dependents?
You will receive one ID card with your name on it. Dependents will not receive separate ID cards. They may use the member’s ID card to access vision benefits.
Ordering or Printing ID Cards
How do I use my benefits and get reimbursed when using an out-of-network provider?
Using out-of-network benefits:
First verify that the provider you wish to see is not in our network. Then, call our Customer Service department at 800-507-3800 to obtain an authorization number to see that provider. Schedule your appointment, and pay the provider directly for the services rendered.
Getting reimbursed when using an out-of-network provider:
Download a Member Reimbursement Claim Form from our website, or call Customer Service at 800-507-3800 to have one sent to you. Complete the form and attach a copy of your receipt or itemized bill that explains what services were provided (keep the original for your records). Contact UsMail or fax these to Superior Vision’s Customer Service department. You will be reimbursed the allowable amount as outlined in the out-of-network section of your Outline of Benefits.
Contact Lens Benefits
What is a Contact Lens Fitting exam?
A Contact Lens Fitting (CLF) exam measures and examines your eyes for the purpose of evaluating and fitting them for contacts. Your provider charges a separate fee for this service. In some Superior Vision plans, the CLF may be an additional, stand-alone benefit – separate from your contact lens benefit. In this instance, you may utilize your CLF benefit, and the costs are not deducted from your contact lens allowance. In some plans, the CLF is not a covered benefit. In this case, the costs will be deducted from your contact lens benefit allowance.
There are two types of CLF:
Standard: Current contact lens user who wears disposable, daily wear, or extended wear lenses only. The Standard CLF is covered in full.
Specialty: New contact lens wearers or those who wear toric, gas permeable, or multi-focus lenses. The Specialty CLF has a retail allowance of $50.
How can I use my elective (cosmetic) contact lens allowance?
You may choose to wear contact lenses in lieu of glasses as your vision correction. The specified allowance may be applied toward the purchase of any type of prescription elective contact lenses. Your benefit is greater when contact lenses are dispensed by an in-network provider.
What are non-elective (medically necessary) contact lenses?
Non-elective (medically necessary) contact lenses are prescribed by a doctor solely for purposes of correcting a specific medical condition, such as keratoconus or other conditions that prevent your vision from being corrected to a specified level of visual acuity using conventional eyeglasses. Choosing contacts over glasses for a standard prescription is considered elective/cosmetic.
Frame & Lens Benefits
How does the retail frame allowance work?
You may select a frame up to your benefit’s specific retail price frame allowance (found on your card or in the benefits coverage section of the secure portal ).
- If you have a co-pay for materials, you will pay that amount when you order your frames and/or lenses
- If the retail price of the frame is greater than your frame allowance, you will pay the difference. Some providers may also give a discount on your out-of-pocket cost for the frame. Refer to your specific Outline of Benefits for more information and details
- If part of the frame allowance is unused, it may NOT be applied to lenses or other benefits
What kind of frame can I select for my insured benefit?
You can select any frame in the in-network provider's frame inventory up to the retail allowance shown in your Outline of Benefits schedule without incurring any additional out-of-network pocket cost.
What discounts are available?
Your specific discount features are listed in the Discount Features section of your enrollment brochure. You may be eligible for discounts off the retail charges for a variety of lens upgrades and add-ons, overages on frame allowances, and/or additional frame and lens purchases. Services must be obtained from a provider indicated in our provider directory as accepting discounts as there are some providers who do not.
How often can I use my discounts?
There are no limits to the number of times you can use the discounts during the contract period of your insured benefit. The discounts are limited to your personal use and that of your covered family members.
Do I need to show my ID card to the provider to use the discounts?
You do not need to show your ID card to the in-network provider to use your discounts benefit, but you do need to tell the provider that you are a Superior Vision member so that they can verify your eligibility. Services must be obtained from a provider indicated in our provider directory as accepting discounts as there are some providers who do not.
Are there any limitations on the frame selection when using the discounts?
Unless otherwise prohibited by the manufacturer, the frame discount may be applied as long as you seek services from a participating provider who accepts discounts.
Can I utilize in-store specials, promotions, or coupons along with my Superior Vision plan benefit?
Your benefits provide discounted rates from in-network providers, and cannot be used in conjunction with coupons, promotions, sales, or other types of discounts. An exception: if you use the services of an in-network provider but choose to take advantage of a sale, coupon, or other in-store special, the provider may require that you pay in full and then submit your receipt to Superior Vision for reimbursement at the out-of-network rates. If you have questions about the use of discounts, call our Customer Service department at 800-507-3800 before you seek services as rules may vary from state to state and be subject to state laws.