Can Heritage Vision Plans service a large corporation?
Yes. We offer our unique brand of personal service for clients as large as Fortune 500 corporations and as small as local neighborhood businesses.
If company representatives or I have questions, who do I contact?
Every company is assigned a knowledgeable Heritage account representative, who will address questions or concerns you may have. A number of online resources are also available.
How can Heritage Vision Plans reduce a company’s vision care plan expenses and still increase the value of the benefit itself?
We are able to offer increased value by: controlling costs, reducing administrative fees, closely managing our provider network, maximizing use of technology, minimizing overhead, and continually improving our processes.
If a company’s vision benefits plan are part of its medical plan, can you offer a Heritage plan without changes to its medical coverage?
Yes. We can “carve out” vision care from the company’s current benefits plan without affecting medical coverage. The transition will be seamless and cost-free to the company.
Agents & Brokers
How extensive is the Heritage Vision Plans Provider Network?
Our network of optometrists, ophthalmologists, and opticians is nationwide and includes more than 31,000 participating network providers.
My client is a large corporation. Can Heritage Vision Plans service it?
Yes. We offer our unique brand of personal service for clients as large as Fortune 500 corporations and as small as local neighborhood businesses.
How will Heritage work with me to design a plan that is right for my client?
We are able to offer increased value by: controlling costs, reducing administrative fees, closely managing our provider network, maximizing use of technology, minimizing overhead, and continually improving our processes.
Is there information available that will help me explain Heritage Vision Plans value to my clients?
Yes. The Heritage website offers a wealth of information, including partner specificFAQ’s. You can also request information.
If a company’s vision benefit is part of its medical plan, can you offer the Heritage plan without changes to the medical coverage?
Yes. We can “carve out” vision care from the company’s current benefit plan without affecting medical coverage. the transition will be seamless and cost-free to the company.
Individual Enrollment
How do I know I need vision insurance?
You never know when you or one of your dependents may experience vision loss. Vision insurance has your back, and can even help you detect health conditions early through regular screening.
What can I expect as a member?
See ourMember FAQs for additional insight on plan benefit usage.
Is there a waiting period?
For individual insurance plans, enrollment is all year! Enroll before the 25th of any calendar month to receive vision coverage starting on the 1st of the following month. So if you enroll on June 24th, coverage will start on July 1st. If you enroll on June 25th, coverage will start August 1st.
Who can buy this plan?
Currently, our individual insurance plan is open to all residents of Michigan.
Who is covered by my vision insurance?
We currently offer plans for both individuals and families. Consult our plan offerings for more details.
What does vision insurance cover?
In any twelve-month period, with applicable Co-Pays, our Core vision plan will cover an eye exam, and either one pair of eyeglasses or contacts; our Enhanced vision plan will cover both eyeglasses and contacts.
How much does the individual plan cost?
Both plans have the option of either an annual or a monthly rate. Insight Core starts at $9.19/mo. (if paid in full for all twelve months at the time of enrollment) or starts at $9.88/mo. (if paid monthly). Insight Enhanced starts at $14.12/mo. (if paid in full for all twelve months at time of enrollment) or starts at $15.18/mo. (if paid monthly).
Where can I use my benefits?
We partner with a broad network of retailers such as Visionworks, MyEyeDoctors, Wal-Mart Vision Center, and Target Optical, as well as hundreds of local providers nationwide. Explore our Provider Search Tool by selecting “National Network” as your network to find a doctor in your area.
Members
Who should I call if I have questions about my plan?
You may call our Customer Service Center toll-free at:
800.252.2053
Monday-Friday: 9am – 8pm EST
Saturday: 9am – 4pm EST
Who is eligible for this plan and can I cover my dependents?
Eligibility to participate in this plan is determined by your employer or group. See your benefit manager for eligibility rules.
If you are not eligible for vision insurance through an employer, Heritage Vision Plans also offers individual enrollment.
What does my plan cover?
Your plan covers most basic vision services and may offer discounts on other products and services purchased from Heritage providers. For more information, Log in to View Your Benefit details.
Do I need an ID card?
No ID card is needed to obtain vision services. Simply give the Heritage provider your identifying information (name, date of birth, and the name of your employer or group).
No change is necessary if your provider participates in the Heritage provider network.
Do I have to select a doctor when I sign up for vision?
No. Once you are eligible for the plan, simply select a provider from the Heritage network.
Do all Heritage providers have the same frame selection?
No. Frame selections vary by location and each offers a wide variety of styles to choose from.
Can I get both contacts lenses and glasses?
If your plan covers materials, you may be eligible to receive contact lenses and glasses as a covered benefit in the same plan year. Often contact lenses are in lieu of eyeglasses. For more information, log in to view your benefit details.
What if I take advantage of a sale, coupon, or other in-store specials at a Heritage provider?
The provider may require that you pay in full and submit your itemized receipt for payment at the out-of-network reimbursement rates. For more information, log in to view your benefit details.
Will I need a reimbursement claim form?
When you visit a Heritage Network Provider all of the paperwork will be handled. There is nothing for you to fill out or send in. If your plan provides an out-of-network or out of area benefit and you choose to use a non-Heritage provider, you may download and completethe reimbursement claim form or click the link below to start the process.
If your plan covers medically necessary contact lenses and your provider determines they are required, you may be eligible if one of the following conditions applies*:
Keratoconus
Irregular Astigmatism
Irregular corneal curvature
Post cataract surgery
Significant Anisometropia
Extreme visual acuity problems not correctable with spectacle lenses
*Prior Approval Required
Is Lasik a covered or partially covered benefit?
A discount is available for Lasik Refractive Surgery at designated locations. For details please visit our Lasik page, Or by calling our Lasik partner toll-free at: 855.373.2020
If I need medical or surgical treatments for eye disease or eye injury, should I go to a Heritage provider?
Your Heritage vision plan covers well-eye services. Coverage for eye disease or eye injury is not a benefit under this plan. If you need help locating a medical provider, please contact your health plan. If you have a medical emergency, call 911 or go to the nearest emergency center.
Open Enrollment
How do I know I need vision insurance?
You never know when you or one of your dependents may experience vision loss. Vision insurance has your back, and can even help you detect health conditions early through regular screening.
When is open enrollment?
For individual insurance plans, enrollment is all year! Enroll by the 15th of any calendar month to receive vision coverage starting on the 1st of the following month. So if you enroll by December 15th, coverage will start on January 1st. If you enroll by January 15th, coverage will start by February 1st.
Will I be able to find a provider?
Our network currently includes over 31,000 providers nationwide. Explore our Provider Search Tool to find a doctor in your area.
Will it cover surgery?
Vision plans cover medically necessary procedures, but not elective surgeries such as LASIK. However, Heritage does offer discounts through our partnerships that can make LASIK surgery more affordable to our members.
What does vision insurance cover?
Vision plans cover basic services, such as the cost of eye exams, as well as prescription glasses or contacts. Additional services that are deemed medically necessary may also be covered depending on your vision plan.
Who is covered by my vision insurance?
Heritage offers plans through employers and service groups that can cover individuals or whole families. Talk to your benefit manager to hear about your options!
What if I miss open enrollment?
You may be able to enroll outside the usual period if you have a qualifying life event. These include getting married, moving to a different health plan area, giving birth, adopting a child, or losing your former coverage.
What is open enrollment?
Open enrollment is a window of opportunity where members can sign up for vision coverage or make changes to their current plan.
Providers
How do I join and qualify to become a Heritage participating in-network provider?
As a prospective Heritage provider, you will undergo a rigorous initial credentialing and verification process before joining the network. We re-credential providers every two years and may conduct on-site quality assurance audits.
Does Heritage Vision Plans accept all types of providers?
Yes. The Heritage Provider Network includes optometrists, ophthalmologists, and opticians. We accept both private practice providers and those affiliated with retail locations or corporate chains.
How often do you process provider claims?
We process clean claims within 48 hours, and we issue payments twice a month.
How should claims be submitted?
Claims may be submitted in one of three ways:
Electronically: PAYER ID is 96462 and EDI Trading Partner is SDS (Smart Data Solutions)
Paper claims mailed to: Heritage Vision Plans, Inc.
Attention: Claim Processing
PO Box 242107
Apple Valley, MN 55124
How will your members know that we are a Heritage Network Provider?
As a Heritage provider, your information will be included in our Heritage Provider Directory. Members will be able to access this information online at Find a Provider or they may contact our Customer Service Center for assistance.
How do I verify coverage for a Heritage member?
Heritage members will provide you with their identifying information (Name, Date of Birth or ID Number, and the name of their employer or covered group).
Prior to rendering services, you may verify member eligibility and determine their level of benefits through our Heritage ProviderWeb Portal. Registration is required.
You may also contact our Customer Service Center at 800.252.2053, Monday – Friday 9am – 8pm EST and on Saturday 9am – 4pm EST, for assistance.
