UMP vision benefits

Regence BlueShield administers medical benefits for the treatment of diseases and disorders of the eyes.

You pay the standard rate under the medical benefit for treatment of diseases and disorders of the eye that are not part of a routine vision exam. Orthoptic therapy is not covered except for the diagnosis of strabismus, a muscle disorder of the eye. LASIK surgery is not covered. Following cataract surgery, vision hardware (contact lenses or eyeglasses, including frames and prescription lenses) is covered and paid at the standard rate.

If you have questions about treatment of diseases and disorders of the eyes, call UMP Customer Service or reference your plan's certificate of coverage.

Vision coverage is provided by UMP, in collaboration with Regence Choice Vision Plan administered by Vision Service Plan (VSP). VSP administers benefits for routine eye exams and hardware (prescription lenses, frames, or prescription contact lenses) and provides claims administration for this plan.
If you have questions about routine eye exams and hardware, call VSP Member Services.

For full details about your UMP vision benefits, read your plan’s certificate of coverage.

You pay $0 of the allowed amount and the plan pays 100 percent of the allowed amount when you see a VSP Choice network provider for one professional, comprehensive routine eye examination with refraction or visual analysis per calendar year, including:

• Prescribing and ordering proper lenses;
• Verifying the accuracy of the finished lenses; and
• Progress or follow-up work as necessary.

When you see an out-of-network provider you pay 100% of the billed charges. VSP will reimburse you up to $45 when you submit a claim for covered services.

When you receive services outside the country, you pay 100% of the billed charges. VSP will reimburse you up to $80 when you submit a claim for covered services.

Lenses for glasses: When you see a VSP Choice network provider, you pay $0 of the allowed amount and the plan pays 100 percent of the allowed amount once every two calendar years for one set of covered glass or plastic lenses:

• Single vision lenses
• Lined bifocal lenses
• Lined trifocal lenses
• Lenticular lenses
• Standard progressive lenses
• Lens enhancement covered for dependent children age 19 or older only:
  • Impact-resistant coating

• When you see an out-of-network provider you pay 100% of the billed charges. When you submit a claim for covered lenses, VSP will reimburse you up to the following amounts:

  • $30 single vision lenses
  • $50 lined bifocal/standard progressive lenses
  • $65 lined trifocal lenses
  • $100 lenticular lenses
• When you receive services outside the country, you pay 100% of the billed charges. When you submit a claim for covered lenses, VSP will reimburse you up to the following amounts:
  • $70 single vision lenses
  • $80 lined bifocal/standard progressive lenses
  • $90 lined trifocal lenses

  • $125 lenticular lenses

Frames: The plan covers one frame every two calendar years.

• When you see a VSP Choice network provider, the plan pays up to $150. You pay any amount over $150.
• When you see an out-of-network provider you pay 100% of the billed charges. VSP will reimburse you up to $70 when you submit a claim for covered frames.
• When you see a VSP approved wholesale/retail vendor the plan pays up to the VSP approved wholesale/retail limit of $80. VSP approved wholesale/retail vendors include both community-based providers, as well as national retail chains. For a list of wholesale/retail vendors, contact VSP Member Services at 1-844-299-3041 or Deaf, DeafBlind, Late Deafened and Hard of Hearing members call (TTY) 1-800-428-4833.
• When you receive services outside the country you pay 100% of the billed charges. When you submit a claim, VSP will reimburse you up to $150.

Contact lenses: The plan covers elective contact lenses or necessary contact lenses in lieu of frames and lenses once every two calendar years.

• Elective contact lenses are contact lenses that are covered under the frame limit in lieu of coverage for eyeglasses.
• Necessary contact lenses are contact lenses that are prescribed by your provider for other than elective or cosmetic purposes. Necessary contact lenses are used to treat specific conditions for which contact lenses provide better visual correction.

When you see a VSP Choice network provider:

• The plan pays up to $150 for elective contact lenses. You are responsible for paying a $30 copay when you receive contact lens evaluation and fitting exam at the time of service.
• The plan pays 100% of the allowed amount for necessary contact lenses. You pay a $30 copay when you receive contact lens evaluation and fitting exam at the time of service.

When you see an out-of-network provider you pay 100% of the billed charges. When you submit a claim, VSP will reimburse you up to the following amounts:

• $105 for elective contact lenses including any fitting/evaluation services

• $210 for necessary contact lenses including any fitting/evaluation services

When you receive services outside the country, you pay 100% of the billed charges. When you submit a claim, VSP will reimburse you up to the following amounts:

• $150 elective contact lenses including any fitting/evaluation services
• $150 necessary contact lenses including any fitting/evaluation services

Get the most out of your UMP vision benefits and save money with a VSP Choice network provider. See the VSP coverage table for adults and dependents ages 19 and over.

Note: Services and supplies are not covered when you see an out-of-network provider.

Vision exam: When you see a VSP Choice network provider, you pay $0 of the allowed amount and the plan pays 100 percent of the allowed amount for one professional comprehensive routine eye examination with refraction or visual analysis per calendar year, including:

• Prescribing and ordering proper lenses;
• Verifying the accuracy of the finished lenses; and
• Progress or follow-up work as necessary.

Lenses for glasses: You pay $0 of the allowed amount and the plan pays 100% of the allowed amount when you see a VSP Choice network provider once every calendar year for one set of covered glass or plastic lenses:

• Single vision lenses
• Lined bifocal lenses
• Lined trifocal lenses
• Lenticular lenses
• Standard progressive lenses
• Lens enhancements:
  • Scratch-resistant coating
  • Ultraviolet (UV) protected lenses
  • Impact-resistant coating

Frames: You pay $0 of the allowed amount and the plan pays 100% of the allowed amount for one covered frame every calendar year when you see a VSP Choice network provider.

Contact lenses:

• You pay $0 of the allowed amount and the plan pays 100% of the allowed amount for elective contact lenses or necessary contact lenses in lieu of frames and lenses once every calendar year when you see a VSP Choice network provider.
• You pay $0 and the plan pays 100% for contact lens evaluation and fitting exam when you see a VSP Choice network provider.

For full vision benefit details read your plan’s certificate of coverage.

Get the most out of your UMP vision benefits and save money with a VSP Choice network provider. See the VSP coverage table for children under the age of 19.

Get the most out of your UMP vision benefits and save money with a VSP Choice network provider. As a UMP member, you may search for a VSP Choice network provider through the VSP website by creating an account and logging into your account or by selecting “Find a doctor” and using the advanced search option, and selecting “Choice” for “Doctor network.”

You can also search for a VSP Choice network provider by signing in to your Regence account, and selecting "Covered services", then "Vision." Your Regence account features single sign-on to VSP allowing you to access your VSP account without maintaining a separate username and password.

• VSP Choice network provider: When you choose to see a VSP Choice network provider for covered preventive vision care, you pay $0 of the allowed amount and the plan pays 100% of the allowed amount. Select a VSP Choice network provider who participates in the Premier Program to receive the best value for lenses and frames or contact lenses. VSP providers who participate in the Premier Program provide access to special offers and savings.
• Out-of-network provider: For members ages 19 and over, out-of-network providers will cost you more. Members under the age of 19 do not have out-of-network benefits.

If you are a UMP member who cannot find a VSP provider within a 25-mile radius, call VSP Member Services. The VSP representative will confirm whether there are no VSP providers within the 25-mile radius and transfer you to the VSP support queue for assistance with the VSP provider access process. The VSP support queue representative will guide you through the process to receive network level reimbursement for routine vision services at an out-of-network provider.

Note: If you see an out-of-network doctor and submit a VSP request for reimbursement form without contacting VSP Member Services first, the claim will process to the out-of-network benefit for adults and deny for members under the age of 19.

To find out more information about the VSP provider network, sign in or create your account at the VSP website.

Visit the VSP website to view your benefits. If logging in for the first time, have your UMP member ID card handy. To create an account:
1. Enter your Member ID (do not use SSN field). You must enter all letters and numbers with no spaces. The last two digits are the numbers next to your name on your card. Example: UDWW71234567800
2. Complete all required fields.
3. Click on "Create An Account".
4. You will receive an email to finish activating your account.

If you are a UMP member who is experiencing trouble getting an appointment scheduled with your VSP doctor, call VSP Member Services at 1-844-299-3041 or (TTY) 1-800-428-4833 for assistance. VSP member services can call the VSP doctor with you on the line, or on your behalf to help schedule an appointment.

For information on how to submit a claim, or file a complaint or appeal visit Claims and appeals.

When you have questions about your VSP coverage or need help finding a VSP Choice network provider, contact VSP Member Services. When you have questions about diseases and disorders of the eye, contact UMP Customer Service.