Vision coverage is offered on most plans. We work with Vision Services Plan (VSP) to make supplemental vision benefits available to members.

Vision Benefits

Vision coverage on most CHPW Medicare Advantage plans includes:

• $0 copay for yearly eye exam
• Prescription eyeglasses or contacts—up to $500 benefit limit per year for MA Dual Plan (HMO SNP) members, and up to $150 benefit limit every two years on all other plans.
• Coverage for exams to diagnose and treat diseases and conditions of the eye (copay/coinsurance may apply)
• Large network of vision providers across WA
  • Vision network directory

Note: Certain eye and vision services are not covered, such as radial keratotomy, LASIK surgery, vision therapy, or low vision aid.

Vision Benefits by Medicare Advantage (MA) Plan

Members must use in-network providers to receive covered services, except in limited cases such as emergencies or urgently needed out-of-area care. With the exception of emergencies or urgent care, it may cost more to get care or purchase hardware from out-of-network providers.

• Medicare-covered exams to diagnose and treat diseases and conditions of the eye are offered through our specialist network.
• Supplemental vision benefits are provided through the Vision Service Plan (VSP) Choice Network.

Please see your plan’s Evidence of Coverage (EOC) or call Customer Service at 1-800-942-0247 (TTY: 711) for more information or assistance finding an in-network provider near you.

MA Plans Vision Benefits

Dual Complete (HMO D-SNP)

$0 or 20% of the cost for Medicare-covered exams to diagnose and treat diseases and conditions of the eye $0 copay for one WellVision exam every year Up to $500 benefit limit every year for supplemental vision hardware (glasses or prescription contacts) Outside of the VSP Choice network: 100% of the cost over the plan benefit limit

Dual Select (HMO D-SNP)

$0 or 20% of the cost for Medicare-covered exams to diagnose and treat diseases and conditions of the eye $0 copay for one WellVision exam every year Up to $500 benefit limit every year for supplemental vision hardware (glasses or prescription contacts) Outside of the VSP Choice network: 100% of the cost over the plan benefit limit

MA Plan 1 (HMO)	Not Covered.
MA Plan 2 (HMO)

MA Plan 3 (HMO)	$0 copay for Medicare-covered exams to diagnose and treat diseases and conditions of the eye $0 copay for one WellVision exam every year Up to $150 benefit limit every two years for supplemental vision hardware (glasses or prescription contacts) Outside of the VSP Choice network: 100% of the cost over the plan benefit limit
MA Plan 4 (HMO)
MA Freedom Plan (HMO)

We’re here to help.

To ask questions, request print copies of materials, and more, contact Customer Service at 1-800-942-0247 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week.