VISION PLAN OF AMERICA EXPLANATION AND BENEFITS

HOW DO YOU RECEIVE CARE?: Upon completion of the processing you will receive a personal identification card. Simply call the office you selected for an appointment as you usually would do. Present your Plan I.D. Card at the time of your appointment. There are no forms to fill out.

WHEN WILL BENEFITS BEGIN?: Those who join prior to the 20th of the month will begin benefits the first day of the following month. For voluntary participants, members must agree to remain enrolled for a minimum of 24 months and pay 24 month full months of coverage even if terminated, once benefits have been utilized. Voluntary benefits are individuals benefits in a group setting and are portable. The individual can take the benefits with them when they leave their employer and can continue payment on their own by personal check or credit card. Children are eligible up to age 19 and extended to age 23 if a full time student and claimed by you for Federal Income Tax purposes.

WHAT IS A VISION PLAN?: A vision plan is a health plan that has contracted with established members of the optometric profession on behalf of the members to provide quality vision care to the members.

Each member receives care in a convenient office by his or her personal plan optometrist.

This type of service offers the economies of group health care...plus the individual attention of private care..

FACILITIES:  Participating optometrists are available for non-emergency care during their regular office hours. Names and locations of the Plans participating offices are located in the List of Participating Optometrists"

PROVIDERS: Providers are located throughout California. After VPA receives your enrollment card, a membership ID will be mailed to you indicating the name, address and phone numbers of the office you've chosen from the list of providers.

ADDITIONAL HIGHLIGHTS:   Guaranteed enrollment, No Waiting period, Pre-existing conditions welcomed, Contact lens benefit included.

DISCLOSURE: 

THIS DISCLOSURE FROM IS ONLY A SUMMARY OF THE VISION PLAN. AFTER YOUR ENROLLMENT IS PROCESSED YOU WILL RECEIVE A COPY OF THE EVIDENCE OF COVERAGE, WHICH WILL DETERMINE THE EXACT TERMS AND CONDITIONS OF COVERAGE IS AVAILABLE UPON REQUEST AT THE PLANS ADMINISTRATIVE OFFICE.

GRIEVANCE PROCEDURE:

THE CALIFORNIA DEPARTMENT OF MANAGED CARE IS RESPONSIBLE FOR REGULATING HEALTH CARE SERVICES. IF YOU HAVE A GRIEVANCE, USE THE PLAN'S GRIEVANCE PROCESS BEFORE CONTACTING THE DEPARTMENT. IF YOU NEED HELP WITH A GRIEVANCE INVOLVING AN EMERGENCY, A GRIEVANCE THAT HAS NOT BEEN SATISFACTORILY RESOLVED BY YOUR PLAN, OR A GRIEVANCE THAT HAS REMAINED UNRESOLVED FOR MORE THAN 30 DAYS, YOU MAY CALL THE DEPARTMENT TOLL FREE AT 1-888-HMO-2219 FOR ASSISTANCE.

FINANCIAL RESPONSIBILITY OF MEMBER:

IN THE EVENT THE PLAN FAILS TO PAY THE PARTICIPATING PROVIDER, THE PROVIDER WILL NOT LOOK TO THE MEMBER FOR PAYMENT. THE MEMBER WILL NOT BE LIABLE.

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