Comprehensive Eye Care Benefits
Vision Care Programs
Two vision programs to meet your needs: Basic Vision reimbursement and N.V.A. Vision with no out-of-pocket costs.
Benefit Periods & Coverage Frequency
How often you can use your benefits
Coverage Schedule
| Service | Frequency |
|---|---|
| Eye Examination | Every calendar year |
| Lenses and Frames | Once every two calendar years* |
| Contact Lenses and Fitting | Every calendar year |
* Lenses and frames may be covered sooner if a lens change of 0.5 diopters or more is required
Exclusions and Limitations
What is not covered
Vision benefits do not cover:
- •Expenses payable under any Workers' Compensation Law
- •Medical or surgical treatment of the eyes, orthoptics, or visual training
- •Replacement of lost, stolen, or broken lenses and frames before the waiting period ends
- •Services or supplies not listed under covered benefits
- •Services or supplies for which no payment is required by the member
- •Services or supplies not prescribed by a legally qualified ophthalmologist, physician, optometrist, or optician
Coordination with Other Insurance
If another source (such as another insurance plan) is responsible for part of the payment, the Fund will pay only the excess amount.
Important Process
Basic Vision Program
Reimbursement-based coverage
The Basic Vision Program provides reimbursement for eligible services after payment.
Benefit Amounts
| Service | Frequency | Benefit Amount |
|---|---|---|
| Eye Examination | Every calendar year | Up to $25.00 |
| Regular Lenses (two) | Every two years (or sooner with lens change) | Up to $24.00 |
| Bifocal Lenses (two) | Same as above | Up to $38.00 |
| Trifocal Lenses (two) | Same as above | Up to $56.00 |
| Frames | Every two years (or sooner with lens change) | Up to $24.00 |
| Contact Lenses (medically required) | Verified by PFT doctor | Up to $80.00 per lens |
| Contact Lenses (not medically required) | Every calendar year | $100.00 allowance |
How to Obtain Benefits
- 1.Download the vision form online or by calling (215) 561-2722
- 2.Choose a legally qualified ophthalmologist, optometrist, or optician
- 3.Complete your portion of the form and have your provider complete theirs
- 4.Send the completed form by mail or email to document@pfthw.org
- 5.Eligible members will be reimbursed directly
Coordination with Davis Vision
N.V.A. Vision Program
Comprehensive care with minimal out-of-pocket costs
Program Purpose
The National Vision Administrators (NVA) program provides:
- •Comprehensive vision analysis (including tonometry test)
- •Lenses with no out-of-pocket cost
- •Selection of frames with no out-of-pocket cost (depending on selections)
- •Cost control for premium frames and cosmetic options
- •Savings up to 50% off retail prices
Covered Services (No Out-of-Pocket Payment)
When using a participating optometrist or ophthalmologist:
- •Eye Examination
- •Frame fitting fee
- •Contact lens fitting fee (if selecting contacts)
- •Regular single or multifocal lenses
- •Frames with a wholesale cost of $24.00 or less
Premium Frames
Contact Lenses
| Type | Coverage |
|---|---|
| Medically required contacts | Up to $80.00 per lens |
| Non-medically required contacts | $100.00 allowance |
Optional Lens Upgrades
Lens and coating options available through participating NVA providers (member pays wholesale or fixed maximum amount):
| Option | Price |
|---|---|
| Polarized | $75 |
| Blue Light Blocker (Standard) | $40 |
| Blue Light Blocker (Premium) | $60 |
| Blue Light Blocker (Ultra) | $150 |
| Photogrey | $12-$30 |
| High Index | $55 |
| Polycarbonate | $25-$30 |
| Anti-Reflective Coating (Tier 1-4) | $10-$80 |
| Progressive (Tier 3-7) | $100-$190 |
Note
Using an Unlisted Doctor
Members may use an unlisted doctor under the Basic Vision Program but should verify whether the provider offers both exams and eyewear services.
Payment and Coordination
- •Your basic benefits are covered by the Fund
- •You pay only for extras (upgrades and premium options)
- •The NVA Vision Benefit may not be coordinated with any other program
How to Use Your NVA Vision Benefits
- 1.View the list of eligible NVA providers
- 2.Make an appointment and notify the provider that your coverage is administered by NVA and sponsored by the PFT
- 3.Receive your eye care services with no out-of-pocket costs for basic services
- 4.Pay for any optional upgrades or premium features directly to the provider
Vision Coverage FAQs
Questions about vision benefits and providers
Questions About Vision Care?
Contact us for questions about eligibility, provider networks, or benefit coordination.
PFT Health & Welfare Fund Office
1816 Chestnut Street, Philadelphia, PA
(215) 561-2722
Contact Page