Save on Exams, Frames, Lenses and More
When you choose a Delta Dental of Arizona individual or family dental plan, you have the option to also take advantage of an affordable, comprehensive vision plan through DeltaVision.
Through our partnership with EyeMed Vision Care, you'll save on eyewear, contacts, exams, and even laser vision correction. EyeMed serves over 140 million people and gives you access to a vast network of vision providers, including independent providers and popular retail locations like LensCrafters, JC Penney, Target Optical, Sears and Pearle Vision.
DeltaVision Individual Benefit Summary
Monthly Premium Rates
(DDAZ Individual Dental plan enrollment required) | Gold Vision Plan |
| DeltaVision Individual | $4.73 |
| DeltaVision + 1 Dependent | $9.46 |
| DeltaVision + 2 or More Dependents | $20.27 |
| Vision Care Services |
Member Cost |
Out-Of-Network |
|
| Exam with Dilation as necessary |
$10.00 copay |
Up to $30 allowance |
|
| Frames |
|
|
|
| Any Frame available at provider location |
$0 copay; $120 allowance
20% off balance over $120 |
Up to $60 allowance |
|
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| Standard Plastic Lenses |
|
|
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| Single Vision |
$10 copay |
$25 |
|
| Bifocal |
$10 copay |
$40 |
|
| Trifocal |
$10 copay |
$55 |
|
| Standard Progressive ** |
$70 |
$40 |
|
| Premium Progressive ** |
$70, 80% of charge
less $110 allowance |
$40 |
|
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| Lens Options |
|
|
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| Standard Plastic Scratch Coating |
$0 |
$5 |
|
|
Contact Lenses
(discount applies to materials only) |
|
|
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| Conventional |
$0 copay; $80 allowance,
15% off balance over $80 |
Up to $64 |
|
| Disposable |
$0 copay; $80 allowance,
plus balance over $80 |
Up to $64 |
|
| Medically Necessary |
$0 copay,
Paid-In-Full |
Up to $200 |
|
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| Frequency |
|
|
|
| Examination |
Once every 12 months |
|
|
| Frame |
Once every 12 months |
|
|
| Lenses or Contact Lenses |
Once every 12 months |
|
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** Standard/Premium Progressive lenses not covered; fund as Bifocal Lens.
Please see the benefit booklet for limitations.
Additional Benefit Information
| ADDITIONAL DISCOUNTS |
IN-NETWORK
MEMBER DISCOUNT |
|
| |
|
| Exam Options |
|
| Standard Contact Lens Fit and Follow up |
Up to $40 |
| Premium contact Lens Fit and Follow Up |
10% off Retail |
| Lens Options |
|
| UV Treatment |
$12 |
| Tint(Solid and Gradient) |
$12 |
| Standard Polycarbonate |
$35 |
| Standard Anti-Reflective Coating |
$40 |
| Other Add-Ons and Services |
30% off Retail Price |
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Member receives a 30% discount on items not covered by the plan at network Providers, which cannot be combined with any other discounts or promotional offers. Discount does not apply to EyeMed provider's professional services, or contact lenses.
Members also receive 15% off retail price or 5% off promotional price for Lasik or PRK from the US Laser Network, owned and operated by LCA Vision.
Members also receive a 40% discount off complete pair eyeglass purchases and a 15% discount off conventional contact lenses once the funded benefit has been used. |
Additional Information
DeltaVision is offered in partnership with EyeMed Vision Care. The network for this plan is the Advantage network. You can use the provider search to find a vision care provider.
Need to add vision to your existing Individual Plan dental coverage? No problem! Just fill out our online enrollment form.
For more information on DeltaVision, please review the following documents:
DeltaVision® is offered through Canyon Insurance Services, Inc., a wholly owned subsidiary of Delta Dental of Arizona, in partnership with EyeMed Vision Care, LLC.
