Cigna Healthy Rewards—Vision Network Savings Program
Important!
If updates are made to the VSP Choice Access Plan, those changes will apply to Cigna’s Vision Network Savings Program.
VSP administers the Vision Network Savings Program under Cigna's Healthy Rewards Program. The program provides savings for routine vision services and materials to all Cigna members through a Cigna Vision provider.
The plan is a VSP Choice Access plan with regional pricing on certain vision services and materials (see below for savings and prices). Prices are determined regionally, and services are available through VSP's Choice Network of doctors. Savings may be used an unlimited number of times during the patient's enrollment as a Cigna member.
There are no authorizations or claims to file—just bill the patient directly after applying the appropriate savings and regional prices.
Eligibility
- All Cigna medical, dental, vision, pharmacy, behavioral health, and voluntary plan members are eligible for the program and can receive savings on routine vision services and materials from a Cigna Vision provider.
- Eligibility for the Vision Network Savings Program will not be available online—you won’t be able to obtain an authorization or file a claim with VSP.
- If the patient has routine coverage available, please use that coverage first.
- The savings are available when patients pay privately for services and materials—they aren’t combined with any other routine vision coverage.
Please Note:
Some Cigna members may have routine benefits directly through Cigna. If benefits can't be verified with VSP, apply the Vision Network Savings Program benefits, charge the patient, and advise him or her to contact Cigna to find out if he or she can submit a claim directly to Cigna.
ID Cards
Most members will have a Cigna ID card with the Cigna logo in the background like the samples below.
Patients with My Care Allies coverage will have ID cards like the one below that don’t have the Cigna logo, but they are eligible for the Vision Network Savings Program.
Claims/Billing & Reimbursement
Important!
There are no authorizations or claims to file—just bill the patient directly.
Exam Coverage
- Charge patient 80% of U&C for exam fees or the regional exam pricing listed below for your region.
- Compare and charge the patient the lower of the two.
- Provide the level of exam needed to determine your patient’s visual health status.
- Savings only applies to services and procedures included in a WellVision Exam. It doesn’t apply to additional diagnoses and treatment.
Materials Coverage
Eligible patients get savings on frames, lenses, lens enhancements, and non-prescription sunglasses and blue light filtering glasses. Use professional judgment when evaluating prescriptions from another doctor.
Please provide the following savings and follow the regional pricing when providing services to Cigna members through the Vision Network Savings Program.
Frame
Savings of 25% on the retail price of the frame.
Lenses
- For all lenses, charge patients 80% of U&C fees or the regional lens prices listed below for your region.
- Compare and charge the patient the lower of the two. There are also region specific pricing for single vision, bifocal, and trifocal lenses.
- Refer to the chart below to determine the appropriate pricing based on your location.
Regional Pricing
Important!
If updates are made to the VSP Choice Access Plan, those changes will apply to Cigna’s Vision Network Savings Program.
Charge patients 80% of U&Cor the prices for your region as indicated below. Patients should be charged the lower of the two amounts.
State |
County(s) |
Region |
Exam |
Single Vision |
Bifocal (Flat Top 28) |
Trifocal (7x28) |
AK |
All |
1 |
$90 |
$50 |
$70 |
$90 |
AL |
All |
4 |
$75 |
$40 |
$60 |
$75 |
AR |
All |
4 |
$75 |
$40 |
$60 |
$75 |
AZ |
All |
3 |
$80 |
$45 |
$65 |
$85 |
CA |
Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano |
1 |
$90 |
$50 |
$70 |
$90 |
All other counties |
2 |
$90 |
$45 |
$65 |
$85 |
|
CO |
All |
3 |
$80 |
$45 |
$65 |
$85 |
CT |
All |
1 |
$90 |
$50 |
$70 |
$90 |
DC |
All |
1 |
$90 |
$50 |
$70 |
$90 |
DE |
All |
2 |
$90 |
$45 |
$65 |
$85 |
FL |
All |
2 |
$90 |
$45 |
$65 |
$85 |
GA |
All |
3 |
$80 |
$45 |
$65 |
$85 |
HI |
All |
1 |
$90 |
$50 |
$70 |
$90 |
IA |
All |
4 |
$75 |
$40 |
$60 |
$75 |
ID |
All |
4 |
$75 |
$40 |
$60 |
$75 |
IL |
All |
2 |
$90 |
$45 |
$65 |
$85 |
IN |
All |
4 |
$75 |
$40 |
$60 |
$75 |
KS |
All |
4 |
$75 |
$40 |
$60 |
$75 |
KY |
All |
4 |
$75 |
$40 |
$60 |
$75 |
LA |
All |
3 |
$80 |
$45 |
$65 |
$85 |
MA |
All |
1 |
$90 |
$50 |
$70 |
$90 |
ME |
All |
3 |
$80 |
$45 |
$65 |
$85 |
MD |
All |
2 |
$90 |
$45 |
$65 |
$85 |
MI |
All |
2 |
$90 |
$45 |
$65 |
$85 |
MN |
All |
3 |
$80 |
$45 |
$65 |
$85 |
MO |
All |
4 |
$75 |
$40 |
$60 |
$75 |
MS |
All |
4 |
$75 |
$40 |
$60 |
$75 |
MT |
All |
4 |
$75 |
$40 |
$60 |
$75 |
NE |
All |
4 |
$75 |
$40 |
$60 |
$75 |
NC |
All |
4 |
$75 |
$40 |
$60 |
$75 |
ND |
All |
4 |
$75 |
$40 |
$60 |
$75 |
NH |
All |
2 |
$90 |
$45 |
$65 |
$85 |
NJ |
All |
1 |
$90 |
$50 |
$70 |
$90 |
NM |
All |
3 |
$80 |
$45 |
$65 |
$85 |
NV |
All |
2 |
$90 |
$45 |
$65 |
$85 |
NY |
Bronx, Kings, Nassau, New York, Richmond, Rockland, Suffolk Queens, Westchester |
1 |
$90 |
$50 |
$70 |
$90 |
All other counties |
3 |
$80 |
$45 |
$65 |
$85 |
|
OH |
All |
3 |
$80 |
$45 |
$65 |
$85 |
OK |
All |
4 |
$75 |
$40 |
$60 |
$75 |
OR |
All |
3 |
$80 |
$45 |
$65 |
$85 |
PA |
All |
2 |
$90 |
$45 |
$65 |
$85 |
PR (Puerto Rico) |
All |
4 |
$75 |
$40 |
$60 |
$75 |
RI |
All |
2 |
$90 |
$45 |
$65 |
$85 |
SC |
All |
4 |
$75 |
$40 |
$60 |
$75 |
SD |
All |
4 |
$75 |
$40 |
$60 |
$75 |
TN |
All |
4 |
$75 |
$40 |
$60 |
$75 |
TX |
All |
3 |
$80 |
$45 |
$65 |
$85 |
UT |
All |
3 |
$80 |
$45 |
$65 |
$85 |
VA |
All |
3 |
$80 |
$45 |
$65 |
$85 |
VT |
All |
3 |
$80 |
$45 |
$65 |
$85 |
WA |
All |
2 |
$90 |
$45 |
$65 |
$85 |
WI |
All |
4 |
$75 |
$40 |
$60 |
$75 |
WV |
All |
4 |
$75 |
$40 |
$60 |
$75 |
WY |
All |
4 |
$75 |
$40 |
$60 |
$75 |
US Virgin Islands |
All |
4 |
$75 |
$40 |
$60 |
$75 |
Lens Enhancements
- Polycarbonate: Charge 80% of U&C fees, not to exceed $40.
- Standard Anti-Reflective Coating (Code QM Only): Charge 80% of U&C fees, not to exceed $45.
- All other Anti-Reflective Coatings (refer to the Product Index): Charge 80% of U&C fees.
- Standard Scratch Coating (Factory Applied Only): Charge 80% of U&C fees, not to exceed $15.
- UV Coating: Charge 80% of U&C fees, not to exceed $15.
- Standard Progressive (Code KA): 80% of U&C fees, not to exceed $55 (only the amount over the base lens-flat top 28)
- Premium and Custom Progressive(Code FA, JA, NA, OA): Charge 80% of additional U&C cost for the progressive (only the amount over the base lens—flat top 28).
- Higher Powers: Charge 80% of additional U&C cost for high powers lenses.
- All Other Lens Enhancements & Features: Charge 80% of U&C fees.
Progressive Lenses
You can use this example to help determine what to bill a patient for a progressive lens. In this example, the practice is located in Arkansas (or Region 4).
Bifocal Base Lens |
|
Bifocal (Flat Top 28) U&C |
$100 |
Deduct 20% ($20) |
-$20 |
Bifocal Lens |
$80 |
Not-to-exceed regional maximum (Region 4 = $60)* |
$60 |
Patient Bifocal Price |
$60 |
Progressive Add-On |
|
Premium Progressive U&C |
$220 |
Minus Bifocal U&C (Use Flat-Top 28) |
-$100 |
Premium Progressive Add-On Price |
$120 |
Deduct 20% ($24) |
-$24 |
Patient Premium Progressive Add-On Price |
$96 |
TOTAL Patient Cost |
|
Bifocal price |
$60 |
Total Patient out-of-pocket for Bifocal and Progressive |
$156 |
*Important!
Please refer to the Lenses section above to determine the appropriate bifocal maximum for your region based on your office location.
Contact Lens Exam Services (Fitting & Evaluation)
- Charge patients 85% of U&C.
Contact Lens Materials
- Charge patients as usual.
Plano Sunglasses and Blue Light Filtering Glasses
- Charge 80% of U&C.
Lab
Lab work can be done on a private invoice basis using any lab, including in-office labs.
LASIK
LASIK discounts are not included through the Vision Network Savings Program administered by VSP. Please have patients contact Cigna Member Services at the phone number or Web site on their ID card for more information.