How Your Vision Benefit Works
Know What’s Covered and How to Use Your Benefit
Original Medicare does not cover routine eye care. Your plan adds routine vision as a supplemental benefit — including annual eye exams, prescription eyewear, and contact lenses — at no additional premium.
Routine Eye Exam
Covered: One routine eye exam for eyewear per calendar year
Your cost: [$0] copayment
Schedule yours once a year through any Superior Vision network provider. Show your Elderplan Member ID card at your appointment.
Prescription Eyewear
Covered: Frames and lenses or contact lenses
Annual allowance: [$375] per calendar year
Your cost: [$0] copayment up to the [$375] limit
How to Use Your Vision Benefit
Using your vision benefit through Super Vision is straightforward. You do not need a referral from your Primary Care Provider.
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Schedule your appointment
Call the doctor directly. Let them know you are an Elderplan member with Superior Vision coverage.
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Show your Elderplan Member ID card
Show your Elderplan card at your vision appointment.
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Your provider handles the rest
Superior Vision network providers submit claims directly to Elderplan on your behalf.
In-Network vs. Out-of-Network Vision Providers
| In-network (Superior Vision providers) | Superior Vision network providers have agreed to the plan’s fee schedule. You receive the full value of your benefit — [$0] exam copayment and the [$375] eyewear allowance applied directly at the point of purchase. |
| Out-of-network vision providers | An out-of-network provider is a health care provider that does not have a contract with Elderplan. Your plan does not cover services received from out-of-network providers, and you will be responsible for the full cost of care. |
Important Reminders About Your Vision Benefit
Things to keep in mind before your appointment:
| Annual limit applies | Your routine eyewear benefit includes a [$375] annual maximum. Once that limit is reached, you are responsible for any remaining costs. Your Flex Benefit can help cover the difference. |
| Benefit resets each calendar year | Your routine eye exam and [ $375] eyewear allowance reset on January 1 each year. Unused benefits do not carry over. |
| Always use your Elderplan Member ID Card | Show your Elderplan Member ID card — not your Medicare card — at all vision appointments, whether routine or medical. |
| Cataract eyewear is separate | Eyeglasses or contacts received after cataract surgery are covered at [$0] and are not counted against your [$375] annual eyewear allowance. The per-surgery limit applies — you receive one pair per cataract surgery, not one pair per eye. |
| Diabetic eye care may be unlimited | If you have been diagnosed with diabetes by a plan provider, you may qualify for an unlimited number of diabetic retinopathy and retinal exams at a [$0] copayment. Contact Member Services to confirm your eligibility. |