The Cleveland Bakers & Teamsters H&W Fund provides their members with an up to $50 total allowance for any individual or combination of the following lens enhancements ordered on the primary Choice Plan benefit:

Anti-reflective coatings, Polycarbonate lenses, Photochromic or Tinted lenses, Progressive lenses, Scratch-resistant coating, UV coating.

The $50 total lens enhancement allowance is available every other calendar year for all relationships except Children under 12 who are eligible every calendar year.

When the patient selects any individual or combination of these lens enhancements, they receive an additional up to a $50 total allowance towards their OOP costs:

• Anti-reflective coatings
• Polycarbonate lenses
• Photochromic or Tinted lenses
• Progressive lenses
• Scratch-resistant coating
• UV coating

Calculate the patient’s OOP expenses for each of the covered lens enhancements ordered above. Patient costs are based on the Choice Plan cost-controls as indicated on the primary authorization.

• Determine the total OOP amount and if it’s $50 or more, deduct the full $50 allowance and bill the patient the difference. If less than $50, then the patient will have no OOP cost for the enhancement(s).
• You will be reimbursed either the $50 allowance or the patient’s OOP expense, whichever is less.

Examples

To receive reimbursement of the lens enhancement allowance, pull the authorization for Additional Pair. It will reflect eligibility for Lenses only.

Bill the Lenses only benefit and indicate the patient’s Total OOP expenses as your dispensing fee. See example above for assistance with calculating.

In the drop-down menu, select Lab 100 for the Additional Pair benefit only.

Reimbursement of the up to $50 allowance will be paid under the Additional Pair benefit which you may need to tie back to the patient's primary Choice Plan EOP for reconciliation.

For assistance concerning this custom benefit, contact VSP at 800.615.1883.