Superior Vision
OVERVIEW OF VISION PLAN
Cary provides
vision coverage through Superior Vision. This is included in Cary's medical
insurance. There is not an additional per paycheck cost for this benefit.
The summary below provides more information on the vision plan.
VISION PLAN BENEFITS FOR TOWN OF CARY
CO-PAYS SERVICES/FREQUENCY
Exam $0 Exam 1 per plan year
Materials $15
Frame* 1 per plan year
Contact Lens Fitting
(standard & specialty)
$15 Contact Lens Fitting 1 per plan year
Lens* 1 pair per plan year
Contact Lenses* 1 allowance per plan year
(based on date of service)
With Superior Vision, you can save the most money by visiting an in-network provider
enrolled in Superior Vision's Discount Program. Please note not all in-network
providers are enrolled in the discount program. Use this step-by-step guide to find or
confirm whether a provider is part of the program to maximize your savings.
If you choose to use an out-of-network provider, those benefits are in lieu of, not in
addition to, in network benefits.
BENEFITS THROUGH SUPERIOR NATIONAL NETWORK
IN-NETWORK OUT-OF-NETWORK
Exam (Ophthalmologist) Covered in full Up to $44 retail
Exam (Optometrist) Covered in full Up to $39 retail
Frames $200 retail allowance Up to $89 retail
Contact Lens Fitting (standard) Covered in full Not covered
Contact Lens Fitting (specialty) $50 retail allowance Not Covered
Lenses (standard) per pair
Single Vision
Bifocal
Trifocal
Progressives
Polycarbonate for dependent children
Basic anti-reflective
Factory scratch coat
High Index 1.6
Photochromic
Ultraviolet coating
Covered in full
Covered in full
Covered in full
Covered in full
Covered in full
Covered in full
Covered in full
Contact Lenses $200 retail allowance Up to $100 retail
Page 18 CARY Benefits Handbook
Vision Insurance
HELPFUL INFO
Benefit Videos
Superior Providers
Superior Vision
L
NEWS FLASH
If your job requires
protective eyewhere,
contact your supervisor,
the Total Employee
Health team, or Talent
& Cultural Consultant
You can save money
by going to in-
network discount
Superior Providers
There's an
App for that!
Up to $34 retail
Up to $48 retail
Up to $64 retail
Up to $48 retail
Not Covered
Not Covered
Not Covered
QUESTIONS?
For any questions
about the plan, claims,
lost ID cards, or other
information, contact
Superior Vision at
1-800-507-3800.
?
*The plan covers up to two $200
allowances toward: 1) two pairs of frames,
2) two sets of contact lenses, OR 3) one
pair of frames and one set of contacts
Covered in full
Covered in full
Covered in full
Not Covered
Not Covered
Not Covered
