United Healthcare Vision Plans

Plan Name:

Plan A

Plan B

  Plan Brochure Plan Brochure
Eye Exam – You Pay:

(Once every 12 Months)

Network Provider: $10 Copay

Non-Network: Any charge over $50 allowance

Frames – You Pay:

(Once every 12 Months)

Network Provider: Any charge over $150 allowance

Non-Network: Any charge over $75 allowance

Lenses – You Pay:

(Once pair every 12 Months)

Network Provider: $10 Copay

Non Network: (See Brochure for allotted allowance)

Contacts – You Pay:

(Once every 12 Months)

(Instead of Glasses) 

Network Provider:

Select Contact Lenses: $0 Copay

Medically Necessary: $0 Copay

Non Select Contacts: Any charge over $125 allowance

Non-Network:

Any charge over $105 allowance

Medically Necessary: Any charge over $210 allowance

(In addition to Glasses) 

Network Provider:

Select Contact Lenses: $0 Copay

Medically Necessary: $0 Copay

Non Select Contacts: Any charge over $150 allowance

Non-Network:

Any charge over $105 allowance

Medically Necessary: Any charge over $210 allowance

Application Fee: None None
Additional Comments: Please review brochure for additional details. Please review brochure for additional details.

***Plan options vary by location and may not be available in all areas.