Medicare Eye Care Benefits
Your Total Eye Care Benefits Solution℠
Ocular Benefits provides our Medicare health plan payers with the highest quality Medicare vision benefits package with exceptional cost containment. In addition to routine Medicare vision benefits we can provide our health plan partners with a totally integrated managed eye care solution that is proven to increase quality and lower cost.
Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.
Eye Exams - GVS offers full coverage for routine eye exams that are preformed by licensed and fully credentialed Doctors of Optometry or Ophthalmologist (M.D.’s).
Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.
LASIK - Discounted LASIK benefits at no additional cost!
Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.
43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide. Including: LensCrafters, PearleVision, JC Penny, Sears Optical, Target Optical. This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.
Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits! Discounts include: lens up-grades/options and additional pair purchases. Members may access this discount program as often as they want during their enrollment in the vision care program. Discounts are available from network provider only.
Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!
Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:
• Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST
• Monday through Sunday: 24 Hours/day IVR system is available.
Medical and Surgical Eye Care - Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures. We offer an integrated medical network that includes primary eye care doctors, eye specialists and eye surgeons. In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.
The use of our fully integrated network has demonstrated to lower overall costs by as much as 20% for our partner Health Plans. In addition to delivering significant cost containment, additional benefits of the integrated network model show up in the form of improved HEDIS scores, member satisfaction and improved administration of benefits.
Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.
Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers. We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model. The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.
Whether it is routine Medicare vision benefits or complex medical-surgical eye care, Ocular Benefits™ will deliver innovative cost-saving eye care solutions and will serve as a strong partner for your organization.
Contact us today to discuss your specific requirements.
