 |
 |
 |
 |
| Quick Links |
|
Plan and Benefits Find a Doctor! Contact PVCS |
Plan and Benefits:
- No Paperwork Required! You need only to make your own appointment with your preferred panel doctor. Required Plan paperwork is completed by your panel doctor. See item 6 for services provided by non-panel doctors.
- Covered Services
- Office calls are covered when needed. Plan pays for all costs of these services.
- Eye examinations, whether intermediate or comprehensive, are covered when needed – not limited to a specific number or frequency of visits. Plan pays for all costs of these services.
- Eyeglass fitting: Plan pays for all service fees for eyeglass fittings. You will be required to pay the "wholesale cost" of the materials (frames and/or lenses) for any eyeglasses ordered. There is no limit to the number of pairs of eyeglasses you may order.
- Contact lens fittings: Original (first time) contact lens fittings are covered for a $50.00 service fee on soft contacts and $75.00 service fee on rigid contacts and the "wholesale cost" of materials (contact lenses).
- Contact lens replacements will not be assessed the $50.00 service fee, but will be assessed "wholesale cost" of materials (contact lenses).
- Eyeglass repairs are performed at no charge unless a cost to the doctor is incurred for replacing a frame part or lens. Patient will be required to pay such cost if incurred.
- Wholesale Cost is defined as a) the current catalog listed price in Frames magazine for eyeglass frames, b) local or customary wholesale laboratory posted rate sheet for eyeglass lenses and options, or c) manufacturers or distributor’s published wholesale per-lens or per-case price for contact lenses plus d) applicable shipping costs and sales tax rounded up to the nearest $5.00.
- Limitations and Exclusions, categorized here as medical eye care, premium services, and luxury frames.
- Medical eye care is defined and covered by most medical insurance plans. Your PVCS doctor can provide many of the services that fall into this category. Your doctor will file with your medical insurance carrier for reimbursement. If not covered by your medical insurance, you will be responsible for medical eye care payments to the doctor.
- Premium services are not covered by this plan. Premium services include non-routine vision services such as vision therapy, laser treatments or refractive surgery, other forms of ophthalmic surgery, photography, corneal topography, orthokeratology, dispensing prescription or non-prescription medications, and technological advancements unknown or not customary and routine at the inception of this contract. Customary and routine services are considered to be those tests and procedures published as standards by the State Board of Examiners in Optometry.
- Non-prescription eyewear (sun or safety glasses) and luxury frames are also excluded from coverage. Luxury frames are those which have a "wholesale cost" over $100.
- PVCS Participating Doctors: An extensive, quality panel of independent optometrists has been assembled to provide service under this plan. Use of these doctors is mandatory and necessary to receive full plan services under these special pricing arrangements. Enrollees who wish to have a non-participating doctor added to the panel are encouraged to have the doctor contact PVCS. PVCS retains the right to determine which doctors are added to the Plan.
- Use of Non-Participating Doctors:
- Inside the State of Oklahoma. PVCS will not reimburse the plan member for services obtained within the State of Oklahoma from a non-participating doctor.
- Outside the State of Oklahoma. Plan members must use a participating doctor if one is available within 30 miles of their residence or place of work. If a participating doctor is not available within this distance, the plan member may seek services from a doctor of his choice. PVCS will reimburse the plan member a portion of the service fee incurred from a non-participating doctor meeting this criterion. The employee must submit an itemized statement of the Doctor’s charges directly to PVCS for reimbursement. This claim must received by PVCS within 90 days of the claimed date of service.
- Discounted Laser Refractive Surgery. PVCS also offers its plan members the opportunity to obtain discounts on laser refractive surgery through:
- The Laser Center (TLC) in Oklahoma City and Tulsa
- The Southern Oklahoma Laser Eye Center in Ardmore
- Omni Eye Center LaserVision in Edmond
PVCS - Primary Vision Care Services
2518 W Gore Blvd - Suite C, Lawton, OK 73505-6315
Phone: 580-357-6912 | Fax: 580-357-6919 | Toll Free: 888-357-6912
Terms of Service | Privacy Policy