Vision and Hearing Benefits (Level I)
Routine eye examinations are essential to maintain healthy eyesight. Through
Davis Vision, you and your eligible dependents are eligible for annual routine
eye examinations and one pair of eyeglasses at no cost, as well as an extra
pair of eyeglasses or contact lenses for a small copayment. This is a self-insured
benefit — vision benefits are not covered as part of your UnitedHealthcare ‘s
Choice Plus coverage.
- When you contact a Davis Vision provider to make an
appointment, the provider will obtain authorization for
services. The authorization will be valid for 30 days.
- You do not need vouchers or ID cards to receive vision
- The Plan provides a discount on Laser Vision Correction
services from participating Davis Vision providers.
- You must receive all services (eye exams, glasses and
or contacts) on the same day, from the same network provider.
What You Need To Do:
- Call the Davis Vision network provider of your choice. You may
locate Davis Vision providers on the www.davisvision.com website
or call the Davis Vision Voice response unit at (800) 999-5431,
or you may contact the Fund Office for a list.
- Identify yourself as a Teamsters Local 251 Health Services and
Insurance Plan member or eligible dependent, and provide the member's
Social Security number and the birth date of your eligible dependent
that need services.
- The provider's office will verify your eligibility for services.
Your Vision Benefits
Every twelve (12) months (to the day) you and/or your eligible dependents
may receive one of the options listed below when you visit a Davis
Eye Exam + Eyeglasses
Eye Exam + Two Pairs of Eyeglasses
Eye Exam + Contact Lenses*
Eye Exam + Eyeglasses + Contact Lenses *
*You may be responsible for a fitting fee.
Once Every 12 Months
No matter which vision service option you elect,
you will not be eligible for another option until 12 months have
The Fund covers the full cost
of lenses and frames included in the Plan's selection. For "non-Plan" frames,
you may receive up to $14 toward part of their cost if they are provided
in the participating provider's office.
You may receive up to $50 toward the purchase of "non-plan" contact
lenses. You are still responsible for the applicable copayments.
In addition to the Plan's standard benefit, you have
access to the following lens options, at no charge to you:
Scratch Resistant lenses
No Claim Forms
There are no claim forms for you to fill out
when you receive vision care services from a Davis Vision
provider. The provider will file your claims for you.
- UV coating
- High index lenses
- Polycarbonate lenses
- Polarized lenses
- Anti-reflective coating
- Photosensitive lenses
- Progressive Addition lenses
- Blended Segment lenses
- Photochromic lenses
- Safety eyeglasses (in lieu of regular eyeglasses)
Replacement Contact Lenses
Call Davis Vision at 1 (800) LENS-123 or go to www.lens123.com to
purchase discounted replacement contact lenses. The program, Lens 1-2-3,
offers guaranteed lowest prices on all name brand contact lenses and
solutions. Operators are available seven days a week (Monday through
Friday, 8:30 am to 8 pm; Saturday, 8:30 am to 5 pm and Sunday 9 am
to 4 pm). Be sure to identify yourself as a Davis Vision Program Participant.
Laser Vision Correction Services
The Plan provides discounts on Laser Vision Correction surgery for
you and your family members. You are eligible for discounts of up to
25% off the usual and customary fees or 5% off any advertised fees,
whichever is lower. (Some providers have flat fees equivalent to these
discounts.) Participating locations are staffed by experienced, credentialed
surgeons who use the latest, most advanced instrumentation. For more
information, visit the Davis Vision website at www.davisvision.com
or call 1-800-999-5431.
The Plan provides hearing benefits such as: screenings,
evaluations, hearing aids, and hearing aid consultation for you and
your eligible family members when you receive care at the Sargent Rehabilitation
Center. The Fund now provides an allowance of $1,000 per aid for digital
hearing aids. This is a self-insured benefit — hearing benefits
are not covered as part of your Choice Plus. You may be responsible
for your plan deductible.
What You Need to Do:
- Obtain a claim form from the Fund Office
- Make an appointment by calling (401) 886-6600
All hearing benefits are provided through the
Sargent Rehabilitation Center at 800 Quaker Lane, Warwick,
Rhode Island 02818. To make an appointment, call (401) 886-6600.
Your Hearing Benefit
You and your eligible dependents are eligible for hearing evaluations
every 12 months through the Sargent Rehabilitation Center. A hearing
evaluation is a full test by an audiologist to determine your ability
to hear sounds and understand speech. If it is determined that you
have hearing loss, you may be eligible for a prescribed standard
or programmable hearing aid.
Hearing Aid Benefits
If you are prescribed a hearing aid, the following benefits will be
provided at no charge to you once every 36 months:
- Ear molds
- Hearing aid
- Fitting supplies
- Initial supply of batteries
- Unlimited office visits for one year
- Related instructions
- Educational information
- Programmable hearing instruments
The Fund now provides an allowance of $1,000.00 per aid for digital
hearing aids. You are responsible for any remaining balance.
Children may need more than one fitting for an ear mold. That's why
the Plan will cover yearly replacements of ear molds, if necessary
through age 18 at no charge to you.