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Each enrolled person may receive an eye exam, lenses, and
frames once each calendar year. Vision plan premiums are
automatically deducted from your pay on a pretax basis.
UM's Kellog Eye Center is a provider for the Vision Plan.
Davis
Vision
Davis Vision, a
national administrator or routine vision care programs,
provides benefits under the Vision Plan. You can receive
benefits in-network or out-of-network. In-network means
you use a provider who is in the Davis Vision provider directory.
If you choose this benefit, you should plan to use in-network services to receive the most from this plan. You may “split” your benefit by receiving your eye examination, frame and spectacle lenses or contact lenses at different time periods or provider locations, if desired. To maintain continuity of care, it is recommend that all available services be obtained at one time from either a network or an out-of-network provider.
Participating
Providers
To use Davis Vision, make an appointment with a participating
doctor when you need vision care services. You will pay
a co-pay (if it applies) when you receive services, and
the balance will be paid through the plan. You will not
have to file any claim forms. To find a Davis Vision provider
in your area, view the Davis Division Web site at http://www.davisvision.com.
Click "Find a Provider" and enter 2032 as the Control Code on the Member Login page, and then click "Submit."
Non-Participating
Providers
If you receive services from a non-Davis Vision provider,
you will be required to pay for the services at that time
and then file a claim with Davis for partial reimbursement.
Before your appointment with a non-participating provider,
obtain a Davis Vision Direct Reimbursement Claim Form from
the Benefits Office Web site, or request to have one sent to you
by sending an email message to benefits.books@umich.edu.
Present the claim form to the non-participating doctor or
laboratory at the time services are provided so they can
complete applicable sections of the claim form.
Keep
a copy of the claim form and your receipt for your records.
Mail the completed and signed claim form with your itemized
receipt to:
Vision
Care Processing Unit
P.O. Box 1525
Latham, NY 12110
A
check will be sent to your home address to reimburse you
up to the allowable expenses listed under Vision
Plan Highlights.
Eye
Exam
Davis Vision provides a comprehensive eye examination, including
a review or your case history, health status of the visual
system, refractive status evaluation, binocular function,
diagnosis, and treatment. Additional fees attributed to
measurements for contact lens fittings are not covered.
Getting
Your Glasses
Davis Vision has developed its own state-of-the-art laboratories
from which all plan lenses are made. Your participating
provider will automatically send your prescription to the
Davis laboratory where your lenses will be made.
Frames
In addition, Davis Vision has contracted with several eyewear
manufacturers to purchase the most up-to-date eyeglass frames.
Included are designer, plastic, metal and “rimless”
eyewear.
You
can choose from Davis Vision’s Fashion, Designer and
Premier Collections. There are approximately 300 frames
to select from, and these collections can be seen in any
participating provider office. There will be an additional
cost for some frames.
There
is a one-year warranty against breakage on all in-network
plan-provided eyeglasses.
Contact
Lenses
Some contact lenses in lieu of eyeglasses are also covered.
Contact Davis Vision to verify that your brand of contacts
is covered before you enroll. See Vision
Plan Highlights for details and associated costs.
ID
Card
No ID Card is issued or needed for the Vision Plan. Davis
Vision will automatically send you a welcome kit and plan
brochure when you enroll.
Questions
If you have questions about the Vision Plan or need a provider
directory, call Davis Vision at 1-800-999-5431.
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