Dental
Vision
Medical Gap
Identity
TeleMed
20% off additional prescription and non-prescription glasses and sunglasses not covered by the benefit.
15% off provider’s UCR
Up to 25% discount off participating provider's UCR or 5% off advertised special (whichever is lower).
You receive the greatest value by staying in-network. If you go out-of-network, pay the provider at the time of service, then submit a claim to Davis Vision for reimbursement.
| Benefit Name | Benefit Amount |
|---|---|
| Exam | Up to $34 |
| Single Vision Lenses | Up to $17 |
| Bifocal Lenses | Up to $30 |
| Trifocal Lenses | Up to $43 |
| Frame | Up to $38.25 |
| Elective Contacts | Up to $100 |
| Benefit | Copay | Frequency |
|---|---|---|
| Eye Exam | $10.00 | every 12 months |
| Rx Glasses | $20.00 | Lenses: every 12 months (in lieu of contacts) Frames: every 24 months |
| Contacts | No Copay | every 12 months (in lieu of lenses) |
If you see a non-VSP provider you will receive a lesser benefit. Before seeing a non-VSP provider, call us at 800.877.7195 for more details.
| Benefit | Reimbursement Amount |
|---|---|
| Exam | Up to $34 |
| Single vision lenses | Up to $17 |
| Lined bifocal lenses | Up to $30 |
| Lined trifocal lenses | Up to $43 |
| Frame | Up to $38.25 |
| Contacts | Up to $100 |
The $35 non-refundable enrollment fee plus your first months premium is due at time of enrollment.
Banking/Saving account: Please allow up to 3 business days.Your vision plan does not cover medical treatment of eye disease or injury; vision therapy; special lens designs or coatings, other than those described herein; replacement of lost eyewear; non-prescription (plano) lenses; contact lenses and eyeglasses in the same benefit cycle; services not performed by licensed personnel; two pair of eyeglasses in lieu of bifocals.
Claim forms are only required if you visit an out-of-network provider. Claim forms are available on the www.davisvision.com member website.
Call 1-800-999-5431 (TTY services available at 1-800-523-2847).
Mon – Fri: 8am – 11pm
Saturday: 9am – 4pm
Sunday: 12pm – 4pm (EST)
Automated help is available 24/7.
Yes; however, you receive the greatest value by staying in-network. If you go out-of-network, pay the provider at the time of service, then submit a claim to Davis Vision for reimbursement, up to the following amounts:
Your eyewear will be delivered to your network provider generally within five business days of order receipt. Special prescriptions, lens coatings, provider frames or out-of-stock frames may delay the standard turnaround time.
Our Collection offers a great selection of fashionable and designer frames, most of which are covered in full. No wonder 8 out of 10 members select a Collection frame. Log on to our Davis Vision member Website at www.davisvision.com and take a look!
You may split your benefits by receiving your eye examination and eyeglasses or contact lenses on different dates or through different provider locations. To maximize your benefit value we recommend that all services be obtained from a network provider.
Insurance 8888593795 will appear on your statement as the charge for your premiums.
If the Applicant or Proposed Insured holds one of these occupations, please check the box next to that individual’s name in the application. These individuals will not be eligible for coverage with the Standard Life product.
If the Applicant or Proposed Insured has had abnormal test results, treatment or been recommended to have treatment for any of the following conditions within the last 5 years, please check the box next to that individual’s name in the application. These individuals will not be eligible for coverage with the Standard Life product.