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Health Net Vision PPO
1. How do I reach Customer Service by phone or fax?
Customer Service Representatives are eager to assist you.
Toll-Free - 866-392-6058
Toll-Free Fax - 866-293-7373
Hours of Operation:
Monday - Saturday 5:00 AM to 8:00 PM (PT)
Sunday 8:00 AM to 5:00 PM (PT)
2. What is the mailing address for Customer Service and Claims?
Health Net Vision
P. O. Box 498488
Cincinnati, OH 45249-8488
Fax claims to 1-866-293-7373
3. What is a vision PPO?
The Health Net Vision plans are PPO plans. The primary distinction is that a PPO allows the member to choose either a contracted PPO network provider, or any licensed vision provider for covered services. You do not need to assign yourself or your covered family members to one particular vision provider.
4. Why should I use a contracted vision provider rather than one that is not affiliated?
Using a PPO contracted vision provider allows you to take advantage of our negotiated contract fees with our providers, thus lowering your out-of-pocket costs. Using out-of-network providers will result in reduced benefits.
5. What are the benefits of selecting eyewear from a contracted vision provider?
When visiting a contracted vision provider, you may select from a wide variety of frames to fit your lifestyle. You can choose traditional, contemporary, or fashion frames. Many providers carry frames from Luxottica, the world's leading frame manufacturer of such brands as Giorgio Armani®, Anne Klein®, Brooks Brothers®, Persol® and others. You should consult with your provider if you have questions about how your vision care plan will be applied to your eyewear selection.
6. Why do I need an eye examination, especially if I haven't had a prescription change or I don't have a vision problem?
An eye examination means more than getting a prescription - it evaluates your eye health and is critical in the early detection of several vision and health-related conditions, including glaucoma, diabetes, cataracts, and hypertension. And because early detection is key for treatment, periodic eye examinations play a vital role in ensuring the health of your eyes. Eye examinations are also important for the health and safety of children. The American Optometric Association recommends that children receive their first eye examination from an eye care professional as early as six months of age. Afterwards, your provider will advise you when your child's next eye examination should be scheduled. Providers are dedicated to preserving your vision, while also making it convenient for you to receive quality eye care.
7. How do I access my vision benefits?
Accessing your benefits is as easy as 1, 2, 3!
8. Will I need to obtain a claim form to receive services?
No, with your Health Net Vision PPO plan, you do not need to obtain a claim form for the in-network services. Simply say to your provider that you are a Health Net Vision PPO member when you make your appointment or visit a participating provider location.
9. Does my plan cover contact lenses?
All Health Net Vision PPO plans offer a contact lens allowance that can be used in lieu of the lens benefits.
10. What is the difference between "medically necessary" and "cosmetic" contact lenses?
"Medically necessary" contacts are a covered benefit for members that have one of four medical conditions:
11. Can I get glasses and contact lenses?
This will vary by your specific plan coverage. In most cases, you may decide to use your benefit towards frames and lenses. Please refer to your Certificate of Coverage for specific plan allowances.
Additionally, your Health Net Vision PPO plan provides discounts up to 45% on secondary purchases through participating providers only after the initial benefit is used. Again, there are no claim forms to process and members have unlimited frequency on these purchases.
12. Does the plan limit the kind of eyeglass frames I can choose?
The Health Net Vision PPO plans allows members to choose from any available frame at a provider location. Members may apply their frame allowance to the frame of their choice, and will receive 20% off any remaining balance - resulting in significant savings on high quality eyewear.
Most independent providers and all LensCrafters locations carry high quality designer frames by Luxottica, which may include: Giorgio Armani®, Anne Klein®, Brooks Brothers®, Persol®, Vogue® and many others.
13. What about extras, such as ultra-violet protection, anti-scratch coating and anti-reflective coatings?
Members will receive scheduled discounts up to 45% on the most popular lens options such as ultra-violet, scratch-resistant and anti-reflective coatings, tints, progressive lenses, and polycarbonate lenses. Additional lens options receive a 20% discount.
14. Does your provider list include all types of eye care professionals?
The network of vision care providers includes ophthalmologists, (MD/DOs), optometrists (ODs), and opticians (RDOs). All providers are carefully credentialed before they are admitted in the network. See below for a description of each.
15. What's the difference between an ophthalmologist, an optician, and an optometrist?
Optometrists (ODs): Doctors of optometry are primary health care providers who examine, diagnose, treat and manage conditions and some diseases of the human eye and visual system. Optometrists are qualified to provide comprehensive eye examinations.
Ophthalmologists (MD or DO): Physicians who specialize in the treatment of disesases and disorders of the eye. Ophthalmologists are qualified to provide comprehensive eye examinations, treat and manage conditions and diseases of the human eye and visual system, and perform eye surgery.
Registered Dispensing Optician (RDO): Opticians, registered with the state Medical Board, who sell, dispense and/or fabricate eyeglasses in accordance with the prescriptions of optometrists and ophthalmologists. Opticians are not qualified to provide eye examinations.
Health Net Vision PPO plans are underwritten by Fidelity Security Life Insurance Company and serviced by EyeMed Vision Care, LLC (together, the "Fidelity Entities"). Discounts on vision care services and products are made available by EyeMed.
Obligations of the Fidelity Entities are not the obligations of nor guaranteed by Health Net, Inc. or its affiliates.