Navigating your employee benefits can sometimes feel overwhelming, especially when it comes to vision care. As an Arizona State University (ASU) employee, you have access to a valuable vision benefit program: the Avesis Advantage Program. This program offers comprehensive eye care coverage to help you maintain healthy vision. Let’s delve into the details of the Avesis Advantage Program, designed specifically for ASU employees, ensuring you understand how to maximize your benefits for optimal eye health.
Program Highlights of Avesis Advantage
The Avesis Advantage Program stands out with several key benefits tailored to meet your vision care needs. This voluntary plan, fully funded by employees, offers extensive access to vision care services throughout Arizona. Here are some of the highlights:
- Extensive Provider Network: Access a wide network of eye care professionals across Arizona, making it convenient to find a provider near you.
- LASIK Surgery Discount: Receive a significant $750 maximum allowance towards LASIK surgery, helping make vision correction more affordable.
- Hearing Discount Plan: Benefit from a hearing discount plan, addressing both vision and hearing health needs.
- Enhanced Contact Lens Allowance: Enjoy an increased in-network allowance for contact lenses, providing greater flexibility in your vision correction choices.
- Optical Purchase Discounts: Take advantage of unlimited discounts on additional optical purchases, allowing for savings on eyewear beyond your primary coverage.
- Yearly Vision Coverage: Benefit from annual coverage for a comprehensive vision exam and eyewear, whether you need glasses or contact lenses.
How to Utilize Your Avesis Advantage Program
To make the most of your Avesis Advantage Program, understanding how to access and use your benefits is crucial. Follow these simple steps to ensure you receive the vision care you need:
- Find a Provider: Visit the Avesis website to locate an in-network provider. Choosing in-network providers is recommended to maximize your benefits and minimize out-of-pocket expenses.
- Schedule an Appointment: Once you’ve selected a provider, schedule your eye care appointment.
- Identify Yourself as an Avesis Member: During your appointment, inform the provider’s office that you are an Avesis member and an employee of the state of Arizona. This will ensure proper billing and benefit application.
By utilizing in-network providers, you can streamline your vision care experience and take full advantage of the benefits offered under the Arizona State University Eye Care Program through Avesis Advantage.
Understanding Out-of-Network Benefits and Claim Procedures
While using in-network providers is generally more beneficial, the Avesis Advantage Program also provides out-of-network benefits for situations where you may choose to see a provider outside of the network. If you opt for an out-of-network provider, it’s important to understand the reimbursement process:
- Payment at the Time of Service: You will be responsible for paying the provider in full at the time of your appointment.
- Claim Submission: To receive reimbursement, you will need to submit a claim to Avesis along with an itemized receipt from the provider.
- Claim Form and Submission: Download the out-of-network claim form from the Avesis member website. Ensure you send the completed form and receipt to Avesis within three months of the service date to be eligible for reimbursement. Reimbursement will be directly issued to you, the member.
Detailed Breakdown of Avesis Advantage Benefits
To provide a clear understanding of your coverage, the following tables outline the in-network and out-of-network benefits offered under the Avesis Advantage Vision Care plan, part of the Arizona State University eye care program.
In-Network Benefits
| Advantage Vision Care | |
|---|---|
| Frequency and Copay | |
| Examination Frequency | Once every 12 months |
| Lenses Frequency | Once every 12 months |
| Frame Frequency | Once every 12 months |
| Examination Copay | $10 copay |
| Optical Materials Copay | $0 |
| Standard Spectacle Lenses | |
| Single Vision Lenses | 100% covered |
| Bifocal Lenses | 100% covered |
| Trifocal Lenses | 100% covered |
| Lenticular Lenses | 100% covered |
| Standard Progressive Lenses | Covered up to $50, plus 20% off retail |
| Selected Tints/Coatings | Up to 20% discount |
| Frame | |
| Frame | Covered up to $100-$150 retail value, $50 wholesale cost allowance |
| Contact Lenses | |
| Elective | 10%-20% discount & $150 allowance |
| Medically Necessary | 100% covered |
| Lasik-PRK | |
| Lasik-PRK | $750 max allowance |
Out-of-Network Benefits
| Advantage Vision Care | |
|---|---|
| Frequency and Copay | |
| Examination Frequency | Once every 12 months |
| Lenses Frequency | Once every 12 months |
| Frame Frequency | Once every 12 months |
| Examination | Up to $50 reimbursement |
| Standard Spectacle Lenses | |
| Single Vision Lenses | Up to $33 reimbursement |
| Bifocal Lenses | Up to $50 reimbursement |
| Trifocal Lenses | Up to $60 reimbursement |
| Lenticular Lenses | Up to $110 reimbursement |
| Standard Progressive Lenses | Up to $60 reimbursement |
| Selected Tints/Coatings | No benefit |
| Frame | |
| Frame | Up to $50 reimbursement |
| Contact Lenses | |
| Elective | Up to $150 reimbursement |
| Medically Necessary | Up to $300 reimbursement |
| Lasik-PRK | |
| Lasik-PRK | Up to $750 reimbursement |
| International Coverage | Covered as out-of-network |
Vision Premiums for Avesis Advantage
The Avesis Advantage Program is designed to be affordable, with premiums deducted directly from your paycheck. Here’s a look at the premium structure for employees under the Arizona State University eye care program:
| 2024 | 2025 | |
|---|---|---|
| Employee | Employee | |
| Employee | $1.72 | $1.75 |
| Employee and Spouse | $5.70 | $5.83 |
| Employee and Child | $5.65 | $5.75 |
| Family | $7.11 | $7.25 |
These nominal premiums ensure access to comprehensive vision care benefits, making the Avesis Advantage Program a valuable component of your Arizona State University benefits package.
Conclusion: Prioritize Your Vision Health with Avesis Advantage
The Avesis Advantage Program, as part of the Arizona State University eye care program, offers a robust and affordable way to manage your vision health. From routine eye exams to significant discounts on eyewear and LASIK surgery, this program is designed to support your vision needs. Take advantage of this valuable benefit to ensure your eyes are healthy and your vision is clear. Enroll during your eligibility period and start utilizing the Avesis Advantage Program today for a brighter, clearer future.
