Vision Plans

 

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Covered California’s Pathway to Vision Coverage

Covered California and VSP® Vision Care have partnered to offer consumers a pathway to vision coverage,

  • $15 exam copay/$25 glasses copay
  • Single vision, lined bifocal, or lined trifocal lenses when glasses are selected versus contact lenses
  • $120 frame allowance or contact lens allowance
  • Contact lens – the fitting and evaluation is fully covered with no copay, allowing members to use their full allowance toward the purchase of contacts

While adult vision care is important for Covered California members, adult vision care is not an essential health benefit under the Affordable Care Act and coverage is handled directly through VSP.   

Vision services for children are an essential health benefit and are included in all health plans purchased through Covered California. Enrollment with VSP into vision plans is available year-round and is available during and outside of the Open Enrollment Period. 

Vision Plan of America

Be sure our broker # 1607 is on your enrollment form.

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Vision Plan of America – Instant ONLINE Quotes & Enrollment – Broker # 1607

Covered CA Certified Agent

Covered CA Certified Agent  
No extra charge for complementary assistance 
Appoint us as your broker  

Set Consultation Meeting via Phone, Skype or Face to Face

Instant Health Quotes & Enroll
including subsidy calculation

Video on how great agents are

"I'm In"

Enrolling in health plans through Covered California has helped people focus on their families and careers, and feel protected against unexpected medical issues.

Guaranteed Issue - No Pre X Clause
Quote & Subsidy Calculation 

Instant complementary quotes & subsidy calculation

Missed Open Enrollment?
See our Special Enrollment page

No charge for our complementary services

Detailed Video Instructions on using our Quote Engine

How to use our FREE Quote Engine, Subsidy Calculator  and get the MOST from the experience.

When you get a FREE quote, you can also see the benefits, view actual brochures, MD and Hospital Lists all ONE easy process with no obligation & it can be anonymous.   Enter your zip code, date of birth, family - household taxation relationships (MAGI - Definition),    Estimated MAGI - Modified Adjusted Gross Income for the upcoming - current year.  Last years tax return only gives an idea so that Covered CA can approve your advance tax credit to help pay premiums.

If you qualify for tax credits - subsidies and want them in advance (Pros-Cons) of filing your taxes click on "Health On Exchange" - Covered CAillustrated below.

This website and are individual consultation are provided to you FREE of Charge!  We are paid by Covered CA and/or the Insurance Companies to help you.  When you fill out the Covered CA ONLINE Application, just appoint us as your agent under Find Help in the Upper Right Hand Corner so that we get paid for helping you.  Click here for screen shots for more detail of how to do it.  If you prefer, you can pay us a consultation fee in lieu of appointing us as your agent, for educational services only.

You can then see all the quotes on the exchange, showing the Cost Share Reduction - Enhanced Silver  if available, subsidy - tax credit amount and your net premium.    If you click "Off Exchange" you will see more plans and companies which  may have larger provider lists.   Scroll down for more screen shots.

Then click on "View Plan Details" - "View Doctor's & Providers" - to compare and get more information.  Please note that the quote engine does not show enhanced silver, but shows silver at 70%.  Check our chart for the better silver coverage.  

Learn more about the right to change plans when Silver Level Enhanced Changes 

To apply, click on apply now or use the links in the right hand column, ON THIS PAGE, but it will have you redo the quote for that specific company.   The price is the SAME, no matter if you use us, go direct to Covered CA or the Insurance Company, as mandated by law!  If applying through Covered CA, be sure to sign the form to appoint us as your agent.  It's not all the easy to figure out how to do it on their website.

If you have any questions email [email protected] or call us 310.519.1335

2 comments on “Vision

  1. I find it interesting that they did not consider vision care insurance essential [10 essential benefits] for adults.

    I’ve been under doctors care for high blood pressure and Type 2 diabetes since the late 1990’s and it’s mandatory to have annual eye exams as part of your Wellness Heath Care.

    • It’s rather technical, but it’s my belief that an eye exam to monitor diabetes and high blood pressure would be covered. Check the vision exclusion in the specimen policy page 118 It refers to benefits if covered under the Medical Portion of the policy. Check the clinical bulletins and see what and how are things covered for each type of disease or illness.

      Clinical Bulletin from Oscar Insurance on when they will pay contact lenses & eyeglasses under the medical benefit.

      Eye exams

      Medicare doesn’t cover eye exams (sometimes called “eye refractions”) for eyeglasses or
      contact lenses. Medicare covers some preventive and diagnostic eye exams:

      • See “Yearly eye exam” under “Diabetes services & supplies” on pages 23–25.
      • See “Glaucoma tests” on page 31.
      • See “Macular degeneration” on pages 38–39.

      Eyeglasses/contact lenses

      Generally, Medicare doesn’t cover eyeglasses or contact lenses. However, following
      cataract surgery that implants an intraocular lens, Part B helps pay for corrective
      lenses (one pair of eyeglasses with standard frames or one set of contact lenses).
      Medicare covers the surgery if it’s done using traditional surgical techniques or
      using lasers.

      In 2018, you pay 100% for non-covered services, including most eyeglasses or contact
      lenses. You pay 20% of the Medicare-approved amount for one pair of eyeglasses or
      one set of contact lenses after each cataract surgery with an intraocular lens, and the
      Part B deductible applies. You pay any additional costs for upgraded frames. Medicare
      will only pay for contact lenses or eyeglasses from a supplier enrolled in Medicare, no
      matter who submits the claim (you or your supplier).

      Glaucoma tests

      Part B covers a glaucoma test once every 12 months if you’re at high risk for glaucoma.
      You’re at high risk if you have diabetes, a family history of glaucoma, are African
      American and 50 or older, or are Hispanic and 65 or older. An eye doctor who’s legally
      allowed to do this test in your state must do or supervise the screening.
      In 2018, you pay 20% of the Medicare-approved amount, and the Part B deductible
      applies. In a hospital outpatient setting, you also pay a copayment. https://www.medicare.gov/Pubs/pdf/10116-Your-Medicare-Benefits.pdf

      See also:

      https://rvaeyecare.com/appointments/vision-vs-medical-coverage

      https://www.refinery29.com/en-us/what-is-an-ophthalmologist-optometrist

      https://www.vsp.com/optometrist.html

      http://www.rochestereyeassociates.com/article.cfm?ArticleNumber=8

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