Beginning Jan 1, 2014, Superior Vision will offer plans that cover “standard” progressive lenses. New and renewing groups will be offered this benefit, and in 2014 you may see many current policies transitioning over to covered progressives.
How Covered Standard Progressives Work.
- Your office decides what progressives lens you consider “standard.” Superior does not define standard progressives by manufacturer, brand, or product.
- Each practice must offer at least one standard progressive lens, and you set the retail fee. Whatever fee you set becomes your Superior patients’ allowance on all progressive lenses.
- Helpful Hint: Whatever standard progressive lens you decide upon, it should probably be the least expensive progressive you can buy since Superior will only reimburse you $90, and you can’t charge the patient the balance on standard progressive lenses. (You can charge patients the overage if they purchase premium progressives.)
- The patient owes nothing on standard progressives. For patients with these new plans, standard progressive lenses are covered in full with the member paying only the materials copay, if applicable.
- If patients choose a premium progressive, the member receives an allowance equal to the standard progressives retail fee you set. The patient then pays the overage, less the 20% discount most private practices’ contracts require.
The secret here will be up-selling to premium progressives. On standard progressive lenses, Superior will reimburse you $90 and you can’t charge the patient more than this. However, on premium upgrades the patient will owe anything above the retail fee you set.
Current policies that just cover a base SV, BF, or TF lens are still in effect for the majority of your Superior plans. For these plans, there is no change in Superior’s benefit structure; you will continue to be paid the same way. However, you may see more policies move to the new progressive option as re-enrollments come up and policies are upgraded to include standard progressives.