Humana offers Full Service or Exam Plus vision coverage plans to help pay for eye care needs. The Humana Plan Year runs July 1 through June 30. Please note that effective July 1, 2022, Mountaineer Flexible Benefits' vision vendor changed from MetLife Vision to Humana.
The member may choose to cover the family by selecting the “Employee & Family” rates. The member may cover a spouse and any children, stepchildren, or foster children up to age 26.
Full Service Vision Plan
This plan covers the employee and family for all routine eye care including eye exams, eyeglass lenses and frames, or contact lenses.
The copayment for materials is $20. A member may receive an examination and contact lenses once every plan year. Contact lenses are in lieu of lenses and frames. A member may receive spectacle lenses every 24 months. In other words, if a member chooses to use the contact lens benefit, this utilizes the lenses and frame benefit. The member would then be eligible for the frame benefit on July 1st. Participants receive a 20 percent discount on additional pairs of prescription glasses or non-prescription glasses, including sunglasses from a Humana Member Doctor.
The member can also receive a 15 percent discount on the participating doctor’s professional fees when purchase prescription contact lenses. This benefit is available in conjunction with the contact lens allowance, or the member can use it to purchase contacts in addition to glasses. These discounts may be used for 12 months following the date of the covered eye examination and are available from any participating Humana Member Doctor.
The Diabetic Eye care Program provides additional coverage through medical diagnosis and procedure codes specifically targeted toward members with Type 1 diabetes.
Exam Plus Vision Plan
This plan is an alternative to the Full Service plan. Under this plan, the employee must obtain services through a Humana member doctor. Benefits include an eye exam once every plan year and discounts on materials and professional services through Humana member doctors. The co-payment is $10 for an eye exam.
For glasses, a 20 percent discount will be applied to a Humana doctor’s usual and customary fee for prescription glasses and spectacle lens options.
For contact lenses, a 15 percent discount will be applied on Humana member doctor’s professional services associated with all prescription contact lenses.
Premiums for these plans are deducted from an employee’s pay, tax-free.
How to Use These Plans
To obtain vision care benefits, you can see any Humana doctor you want or use a non-member doctor. Call a Humana member doctor, identify yourself as a Humana patient, and make an appointment. The doctor’s office will verify your eligibility and plan coverage and obtain authorization from Humana. The doctor will explain any additional charges. After you pay your copay, the doctor will take care of all the paperwork.