Primary Vision Care Services
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Plan and Benefits
No Paperwork Required!
You need only to make your own appointment with your preferred panel doctor. Required Plan paperwork is completed by your panel doctor. See item 6 for services provided by non-panel doctors.
, whether intermediate or comprehensive, are covered when needed – not limited to a specific number or frequency of visits. Plan pays for all costs of these services.
All materials are offered at wholesale cost. There is no limit to the number of pairs of prescriptive eyeglasses. The plan will pay a service fee to the provider for each pair of eyeglasses dispensed. Contact Lenses are limited to annual supplies.
Members are eligible for both glasses and contact lenses in the same plan year.
Contact lens fittings:
Original (first time) contact lens fittings and major re-fittings (ex: sphere to toric) are covered for a $50.00 service fee on soft contacts; a $75.00 service fee on rigid contacts; and a $150.00 service fee on hybrid contact lenses, including Synergeyes contact lenses, and the "wholesale cost" of the materials.
Contact lens replacements
be assessed the service fees, but will be charged "wholesale cost" of materials (contact lenses).
are performed at no charge unless a cost to the doctor is incurred for replacing a frame part or lens. Patient will be required to pay such cost if incurred.
is defined as a) the current catalog listed price in
magazine for eyeglass frames, b) local or customary wholesale laboratory posted rate sheet for eyeglass lenses and options,
c) manufacturers or distributor’s published wholesale per-lens or per-case price for contact lenses
d) applicable shipping costs and sales tax rounded up to the nearest $5.00.
Limitations and Exclusions
, categorized here as medical eye care, premium services, luxury frames, premium lenses, and non-prescription eyewear.
• Medical eye care is defined and covered by most medical insurance plans. Your PVCS doctor can provide many of the services that fall into this category. Your doctor will file with your medical insurance carrier for reimbursement. If not covered by your medical insurance, you will be responsible for medical eye care payments to the doctor.
• Premium services are not covered by this plan. Premium services include non-routine vision services such as vision therapy, laser treatments or refractive surgery, other forms of ophthalmic surgery, photography, corneal topography, Orthokeratology, dispensing prescription or non-prescription medications, and technological advancements unknown or not customary and routine at the inception of this contract. Customary and routine services are considered to be those tests and procedures published as standards by the State Board of Examiners in Optometry.
Note: Orthokeratology (by whatever associated name)
is not covered
by this plan. Doctor will charge his usual and customary fee, less PVCS reimbursement for a routine eye exam and contact lens fitting.
Luxury frames are frames with a "wholesale cost" of more than $125. Luxury frames will receive a 20% discount.
Premium lenses are prescription lenses with a "wholesale cost" or more than $300.00 (not including lens options, tints, coatings, etc). Premium lenses will receive a 20% discount.
Non-prescription eyewear (sun or safety glasses) is not covered by this plan.
PVCS Participating Doctors:
An extensive, quality panel of independent optometrists has been assembled to provide service under this plan. Use of these doctors is mandatory and necessary to receive full plan services under these special pricing arrangements. Plan members who wish to have a non-participating doctor added to the panel are encouraged to have the doctor contact PVCS. PVCS retains the right to determine which doctors are added to the Plan.
Use of Non-Participating Doctors:
Inside the State of Oklahoma
reimburse the plan member for services obtained within the State of Oklahoma from a non-participating doctor.
Outside the State of Oklahoma
. Plan members must use a participating doctor if one is available within 30 miles of their residence or place of work. If a participating doctor is not available within this distance, the member may seek services from a doctor of his choice. PVCS
reimburse the member a portion of the service fee incurred from a non-participating doctor meeting these criteria. The member must submit a paid itemized statement of the doctor’s charges directly to PVCS for reimbursement. This claim must be received by PVCS within 90 days of the claimed date of service.
Discounted Laser Refractive Surgery
. PVCS offers its plan members the opportunity to obtain discounts on laser refractive surgery through nJoy Vision in Oklahoma City. Call PVCS for current fees.
Last revised: 2/10/2021
Terms of Service
Individual Terms of Service
"The service provided herein is not insurance. State insurance insolvency guarantee funds are not available for your use in the event of insolvency or liquidation of this company"
The PVCS plan is considered to be a Direct Care Plan by the Oklahoma Insurance Department and is governed by the Department pursuant to 36 O.S. Section 632.