Heritage Vision Benefit Summary & Directory - Wayne County

Vision Benefit Plan | Certificate of Coverage

U

Vision Benefit Web Site: www.heritagevisionplans.com

WAYNE COUNTY

COMMUNITY COLLEGE

WAYNE COUNTY COMMUNITY

COLLEGE DISTRICT

Table of Contents

SECTION II USING YOUR BENEFIT PLANUsing a Network ProviderClaims AppealsUnresolved Concerns

page 5 page 6 page 6

Heritage Vision Plans 1

WELCOME TO HERITAGE VISION PLANS

WAYNE COUNTY COMMUNITYCOLLEGE DISTRICT BENEFITS

SECTION I

page 2

MEMBER RIGHTS/PRIVACY PRACTICES

NOTES/APPOINTMENTS

Different Types of Prescription LensesEyeglass Lens MaterialsEyeglass Lens Coatings and Options

page 10page 11page 12

page 13

page 14

Scope of CoverageWhat's Not Covered

page 3 page 4

GLOSSARY OF EYEWEAR TERMS

FREQUENTLY ASKED QUESTIONS page 8-9


TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


SECTION III PROVIDER DIRECTORY

page 9

page 10-15

WEB SITE: HOW TO USE


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 16


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 3page 4


NOTES/APPOINTMENTS



page 13

page 14




TRUST PLANBENEFITS

SECTION I

page 2


page 17 page 18 page 19


page 3page 4


In t roduct ion

Heritage Vision Planshas developed this guide to help you receive maximum value fromyour vision benefit. Thishandbook covers important topics such as:what services are covered, accessing aprovider, filing a claim,and member rights andprivacy practices.

Heritage Optical 2

WELCOME Wayne Cty CommunityCol lege Distr ict Employees!

We are glad to have you as members of the HeritageVision Plans family. Heritage is a vision benefit management company that is dedicated to providingexceptional service, world-class quality and an extensiveprovider network.

Heritage is committed to the quality, reliability andservice excellence that have made us successful since1975. Our goal is to provide you with the best in eyecare and service.

We are providing this booklet to enable you and your covered dependents to make the best possible use of yourvaluable vision care benefit. If you have questions that arenot answered here, please call us toll-free at 1-888-322-0919, or e-mail us at [email protected].

Cordially,

George P. Barnes, Jr.PresidentHeritage Vision Plans


1

You are eligible for contact lenses OR glasses, not both, in any 12 month consecutive period. 2

Designated locations can be found at www.heritagevisionplans.com/unibar

FORD MOTOR COMPANY BENEFIT PLAN

EligibilityYour eligibility and/or your dependent(s) eligibility to par- ticipate in this Plan is determined by Ford Motor Company.

Scope of Coverage

SAMPLE COMPANY BENEFIT PLAN

Scope of CoverageYour Scope of Coverage is determined by (SampleCompany). This section of the Vision Benefit Handbookwill explain your plan benefit. The following chartindicates what services are covered, how often eachcovered service can be used, what you can expect topay when receiving services from an in-network providerand what your reimbursement amounts will be whenreceiving services from an out-of-network provider.

He 3

)(SAMPLE COMPANY BENEFIT PLAN

Scope of Coverage

Your Scope of Coverage is determined by (SampleCompany). This section of the Vision Benefit Handbookwill explain your plan benefit. The following chartindicates what services are covered, how often eachcovered service can be used, what you can expect topay when receiving services from an in-network providerand what your reimbursement amounts will be whenreceiving services from an out-of-network provider.


)(Scope of Coverage

Your Scope of Coverage is determined by (SampleCompany). This section of the Vision Benefit Handbookwill explain your plan benefit. The following chartindicates what services are covered, how often eachcovered service can be used, what you can expect topay when receiving services from an in-network providerand what your reimbursement amounts will be whenreceiving services from an out-of-network provider.


Your eligibility and/or your dependent(s) eligibility to par- ticipate in this Plan is determined by Wayne County Com-

3

Your Scope of Coverage is determined by the CoveredGroup. This section of the Vision Benefit Handbook willexplain your plan benefit. The following chart indicateswhat services are covered, how often each covered ser-vice can be used, and what you can expect to pay whenreceiving services from an in-network provider.

1You are eligible for contact lenses OR glasses, not both, in any _________benefit period.

Your Scope of Coverage is determined by Ford. Thissection of the Vision Benefit Handbook will explainyour plan benefit. The following chart indicates whatservices are covered, how often each covered servicecan be used, what you can expect to pay when receivingservices from an in-network provider and what yourreimbursement amounts will be when receivingservices from an out-of-network provider.

ge Optical 3

SEIU LOCAL 79 STAFF PLAN

Scope of Coverage

Your Scope of Coverage is determined by Wayne County Community College District. This section of the Vision Ben- efit Handbook will explain your plan benefit. The followingchart indicates what services are covered, how often eachcovered service can be used, what you can expect to paywhen receiving services from an in-network provider.

Sect ion IWAYNE COUNTY COMMUNITY COLLEGE DISTRICT - VISION BENEFIT PLAN

munity College District.


SERVICES COVERAGE

FREQUENCY IN-NETWORK:

COVERAGE

Comprehensive Eye Exam For Eyeglasses

(Does not apply to Contact Lens Exam)

Once every 24 months

(from date of last exam) Fully Covered, No Co-pay

Frames Once every 24 months

(from date of last purchase) Covered up to a $125 maximum

Lenses: (Choice of One)

Single Vision Once every 24 months

(from date of last purchase) Fully Covered, No Co-pay

Bifocal Once every 24 months


Trifocal Once every 24 months


Lenticular Once every 24 months


Lens Options:

Tint (Therapeutic Rose Tint #1 or #2)



Frame Warranty (1 year manufacturer’s)



OR Contact Lenses - $129.00 Allowance towards Exam and Contact Lenses

Comprehensive Eye Exam For Contact Lenses

1

(Applies to Contact Lens Exam and Fitting)


(from date of last purchase)

Contact Exam and Fitting:

Covered up to a $64.50 maximum

Contacts Lenses 1

(includes disposables)


(from date of last purchase)

Contact Lenses:

Covered up to a $64.50 maximum

1You are eligible for contact lenses OR glasses, not both, in any 24 Month Consecutive Period.

Heritage Optical 4Heritage Vision Plans 4

What’s Not Covered

Products and services not covered under the planinclude:

· Non-prescription lenses· Two pairs of glasses instead of bifocals· Lenses and frames furnished under a plan, that are

lost or destroyed· Parts or repair of frame not covered under

manufacturers' warranty· Medical or surgical treatment of the eyes· Drugs or medications· Corrective vision services, treatments, and materials

of an experimental nature· Services not visually necessary· Industrial (3mm) safety lenses and safety frames

with side shields· Any services not specified in the Wayne County

Community College District Scope of Coverage

Heritage Optical 5

USING YOUR BENEFIT PLAN

Using a Network Provider

Here are the steps to take:

1. Select a doctor from the list of network providers. The l ist can be accessed on our Web si te:www.heritagevisionplans.com or by calling ourInteractive Voice Response (IVR) System toll-free at:1-800-608-0410. The Interactive Voice ResponseSystem is available seven days a week, 24 hours aday.

2. Make an appointment with the doctor of your choice.When calling to make an appointment, identify yourselfas a WCCCD Employee and a H eritage VisionPlans Member. The Provider will ask for your ID Num-ber (member's SSN) and (the patient's) Date of Birth.

3. The Doctor / Provider will verify your eligibilityand/or eligibility of dependents.

4. When the examination is complete and you and/oryour dependents have been fitted for any necessaryglasses or contact lenses, the doctor will explain anyadditional charges that you may have to pay.

5. The Doctor / Provider will take care of all the paper-work. There are no claim forms for you tocomplete.


Sect ion I I

As a Heritage VisionPlans member, youwill maximize benefitsand reduce out-of-pocketcosts by choosing to visitan In-Network Provider.

Cla ims Appeals / Unreso lved Concerns

6.

Claims Appeals

If a claim is denied, in whole or in part, Heritage willnotify you of the reasons for denial. Within 60 daysafter the date of the denial notice, you may make awritten request for review of the denial. The requestmust include any and all supporting documentation.The claim will be reviewed and you will be notified ofthe decision. Submit claim appeals to:

Heritage Vision Plans, Inc.ATTN: Claims Appeal Manager 440 E. Congress, Suite 300Detroit, MI 48226

Unresolved Concerns

resolution of any customer service issue you may have,please contact your Human Resources Department representative. After exhausting all avenues to haveyour concerns satisfactorily addressed, you may contact:

Health Plans DivisionOffice of Financial and Insurance Regulation611 W. Ottawa, Third FloorP.O. Box 30220


If you are not satisfied with Heritage Vision Plans'

Lansing, MI 48933


FREQUENTLY ASKED QUESTIONS

Q: Do I need an ID card?A: Yes, you will use your Blue Cross Blue Shield of

Michigan ID card. When you call f or an appoint-ment with a provider, the provider will v erify youreligibility. The provider will ask for your MemberID number and (Patient's) Date of Birth.

Q: How can I obtain a list of vision careproviders in your network?

A: Heritage Vision Plans offers a provider locator onour Web site: www.heritagevisionplans.com andby calling our toll-free number: 1-800-608-0410.

Q: Where do I get a claim form to submit forreimbursement?

A: If you visit an in-network provider, there is no claimform to submit. The provider will handle all of thepaperwork and will submit the claim. If you visit anout-of-network provider, you must get an itemizedreceipt from the provider and submit that receipt toHeritage Vision Plans for reimbursement. Thereceipt will serve as the claim form. Please seePage 6 for a complete description of what theitemized receipt must contain.

Q: Where do I send my itemized receipt forreimbursement?

A: Send the itemized receipt to: Heritage Vision PlansATTN: Vision Claims Reimbursement18984 Livernois Avenue, Suite BDetroit, MI 48221

FAQ


FREQUENTLY ASKED QUESTIONS

Q: Do I need an ID card?A: No, you do not need an ID card. When you call

for an appointment with a provider, the providerwill verify your eligibility. The provider will ask foryour Member ID number which is your SocialSecurity Number.

Q: How can I obtain a list of vision careproviders in your network?

A: Heritage Vision Plans offers a provider locator onour Web site: www.heritagevisionplans.com andby calling our toll-free number: 1-800-608-0410.

Q: Where do I get a claim form to submit forreimbursement?

A: There is no claim form to submit. When you visit theHeritage network provider, the provider will handleall of the paper work and will submit the claim.

FAQ

Q: Do all optical locations have the sameframes to choose from?

A: No, the frames will differ by location, but each loca-tion will have a wide variety of styles to choose from.

Heritage Optical 9

Q: How can my current doctor join the network?

A: You may refer your doctor to us for inclusion in our network. Request that your doctor contact our Director of Provider Relations at 1-888-322-0919 ext. 1506 for an application packet, or e-mail us at [email protected]

Q: Can I get both contact lenses and glasses?A: You are eligible to receive contact lenses OR glass-

es in the same Plan Year as a covered benefit. Ifyou wish to purchase both in the same Plan Year,you may receive a preferred pricing discount on thenon-covered item.

Q: Is Lasik a covered or partially covered benefit?A: Lasik is not a covered or partially covered benefit

under the MPS Group's Scope of Coverage.

Q: How do I know which of the toll-free numbers listed in this book to use?

A: If you need information regarding eligibility orprovider locations, use the 1-800-608-0410 tollfree number. This will connect you to the CustomerService Center or IVR system.

For all other member service needs, please use the 1-888-322-0919 toll free number. This will connectyou to Heritage Vision Plans' administrative offices.

FAQ cont inued


Q: Do all optical locations have the sameframes to choose from?

A: No, the frames will differ by location, but each loca-tion will have a wide variety of styles to choose from.

Q: How can my current doctor join the network?

A: You may refer your doctor to us for inclusion in our network. Request that your doctor contact our Director of Provider Relations at 1-888-322-0919 ext. 1506 for an application packet, or e-mail us at [email protected]

Q: Can I get both contact lenses and glasses?A: You are eligible to receive contact lenses OR glass-

es, not both, in the same Plan Year as a coveredbenefit.

Q: Is Lasik a covered or partially covered benefit?A: Lasik is not a covered or partially covered benefit

under the Wayne County Community College Dis-

Q: How do I know which of the toll-free numbers listed in this book to use?

A: If you need information regarding eligibility orprovider locations, use the 1-800-608-0410 tollfree number. This will connect you to the CustomerService Center or IVR system.

For all other member service needs, please use the 1-888-322-0919 toll free number. This will connectyou to Heritage Vision Plans' administrative offices.

FAQ cont inued

trict Scope of Coverage.


Click the “member login” Button


www.heritagevisionplans.com (Snapshot of Home Page)

Please note the log-in is sensitive to entry format. All ID dashes (-)and date slashes (/) need to be entered like the example below.

>Date of Birth: mm/dd/yyyy

>9-digit ID Number: (SSN Format) xxx-xx-xxxx

Click the “member login” Button

Web S i te : How To Use

Step 1: Go to the Heritage Vision Plans WebsiteThe Heritage Vision Plans Web site is www.heritagevisionplans.com

Step 2: Select Member Login

of the web page (see example below).

Step 3: Login

Social Security Number (SSN) and the Primary Member's Date of Birth. After logging in, you will have full member access to

C

At the secure login screen, enter the Primary Member's 9-digit

Click the "member login" button in the upper right corner

Her i tage

the WCCCD vision benefit information.your eligibility information, the Provider Search Engine, and

Heritage Optical 5

www.heritagevisionplans.com 1-800-608-0410

Sect ion I I I

HHeerriittaaggee OOppttiiccaall 190

Participating Provider information is subject to change without notice. Please call Providers, listed in this Directory, to verify their continued participation in the Heritage Provider Network, prior to scheduling your appointment or receiving services. The Heritage Vision Plans Web site (www.heritagevisionplans.com) or toll-free Automated Provider Locator (800-608-0410) will always be your source for the most up-to-date Participating Provider Directory for your vision care plan.

Instaset Plastic Corporation


Provider Directory

Provider Directory

Wayne County Community College District

ALLEN PARK Rx Optical

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Natalie M. Sorce O.D. Matthew S. Haubert O.D. 23055 Outer Drive Allen Park, MI 48101 (313) 359-9075

AUBURN HILLS Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 3021 Walton Boulevard Auburn Hills, MI 48326 (248) 364-2020

Pontiac Eye Clinic


Michael Weishaus O.D. Randall M. Weishaus O.D. Max Gottesman O.D. Lorne M. Gottesman O.D. 4151 Baldwin Road Auburn Hills, MI 48326 (248) 858-2223

BATTLE CREEK Rx Optical


Gerald E. Hanna O.D. 65 E. Columbia Avenue Battle Creek, MI 49015 (269) 965-5106

BELLEVILLE Belleville Vision Center


Barry K. Lesnick O.D. 10788 Belleville Road Belleville, MI 48111 (734) 697-6671

BENTON HARBOR

Rx Optical


Karl K. Damm O.D. 1761 S. M-139 Benton Harbor, MI 49023 (269) 934-0424

BRIGHTON Pearle Vision (Formerly D.O.C)


Randy Watsky O.D. 8709 W. Grandriver Brighton, MI 48116 (810) 220-4499

BROWNSTOWN Redford Optical


Jennifer A. Ciak O.D. 23768 West Road Brownstown, MI 48183 (734) 692-7763

CANTON Pearle Vision (Formerly D.O.C)


Jeffrey S. Hagan O.D. 43271 Ford Road Canton, MI 48187 (734) 981-8111

Visionpro Eyecare


Barry K. Lesnick O.D. 7237 N. Canton Center Road Canton, MI 48187 (734) 416-5005

Elite Eyecare Center


Daniel J. Trainor O.D. Andrew H. Schmitzer O.D. 44750 Ford Road Canton, MI 48187 (734) 455-3190 Sharper Vision


Jacquelyn Blakey O.D. 1675 Canton Center Road Canton, MI 48187 (734) 927-9963

CHARLOTTE

Rx Optical


Linda L. Goeman-Stahl O.D. 1315 Lansing Road Suite B Charlotte, MI 48813 (517) 543-7577

CHESTERFIELD Pearle Vision (Formerly D.O.C)


Arlene Barton O.D. Michael Weisberger O.D. 27903 23 Mile Road Chesterfield, MI 48051 (586) 598-3935

CLAWSON House Of Optical


Mark J. Simard O.D. Robert R. Feldman O.D. 329 W. 14 Mile Road Clawson, MI 48017 (248) 435-3400

CLINTON TWNSHP

Metro Vision II


Gerald J. Blazius O.D. 39087 Garfield Road Clinton Township, MI 48038 (586) 286-7200

COLDWATER

Rx Optical


Joseph M. Hibler O.D. Gerald E. Hanna O.D. 755 E. Chicago Street Coldwater, MI 49036 (517) 278-9004

DEARBORN Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 23469 Michigan Avenue Dearborn, MI 48124 (313) 565-5600

Henry Ford Optimeyes


William C. McIntyre O.D. Beverley J. Katz O.D. 22850 Michigan Avenue Dearborn, MI 48124 (313) 562-8000



Tatjana Ratzenberger O.D. Beverley J. Katz O.D. 19401 Hubbard Drive, 2nd Floor Dearborn, MI 48126 (313) 982-8297

Midwestern Vision Center


Howard J. Rosner O.D. 5050 Schaefer Road Dearborn, MI 48126 (313) 582-8080

DEARBORN HTS. Redford Optical


Jennifer A. Ciak O.D. 23320 Ford Road Dearborn Heights, MI 48127 (313) 562-4733

DETROIT Heritage Optical Center


Robert Kocembo O.D. Michael J. Lowe O.D. 19010 Livernois Avenue Detroit, MI 48221 (313) 863-9581

Heritage Optical Center


Robert Kocembo O.D. 87 Monroe Street Detroit, MI 48226 (313) 965-2740 Heritage Optical Center


Robert Kocembo O.D. 2678 E. Jefferson Avenue Detroit, MI 48207 (313) 259-6006 Black & White Look Optical


Myron J. Gerber O.D. 12871 E. Jefferson Suite A Detroit, MI 48215 (313) 331-1701



Ayaz M. Khan O.D. Beverley J. Katz O.D. Henry Ford Hospital 2799 W. Grand Blvd, 1st Floor Detroit, MI 48202 (313) 916-2020



Timothy J. Guthrie O.D. Beverley J. Katz O.D. 7800 W. Outer Drive, 1st Floor Detroit, MI 48235 (313) 387-8800

Health Center Optical


Robert F. Lee O.D. 4201 Saint Antoine Street Detroit, MI 48201 (313) 745-4750

Belmont Vision


Lowell Ressler O.D. 1936 E. 8 Mile Road Detroit, MI 48234 (313) 369-2020

Optical World


Michael Weishaus O.D. Randall M. Weishaus O.D. Max Gottesman O.D. Lorne M. Gottesman O.D. 15336 Grand River Ave Detroit, MI 48227 (313) 836-1666

Rosedale Eye Care


Seymour R. Rosen O.D. 19460 Grand River Avenue Detroit, MI 48223 (313) 533-4003 Murray A. Feldman O.D.


4851 Michigan Avenue Detroit, MI 48210 (313) 895-0102


EASTPOINTE

Normandy Optical


Gerald J. Blazius O.D. Mark J. Simard O.D. 22561 Gratiot Avenue Eastpointe, MI 48021 (586) 775-6733

W. Fraser Vipond M.D. & Oxford Optical


20919 Gratiot Avenue Eastpointe, MI 48021 (586) 774-2626

FARMINGTON HLS.



Barry A. Bell O.D. Anna M. Santillan O.D. Rovetta M. Mattia O.D. Beverley J. Katz O.D. 38487 W. 10 Mile Road Farmington Hills, MI 48335 (248) 477-9300

FLINT Riverfront Optical


Scott McDowell O.D. Marla Hayden O.D. G-4325 Miller Road Flint, MI 48507 (810) 230-9292 Riverfront Optical


Francis Stone O.D. Marla Hayden O.D. 3724 Davison Road Flint, MI 48506 (810) 742-3500

FORT GRATIOT Henry Ford Optimeyes


Charles G. Shermetaro O.D. Kimberly A. Sebok O.D. Beverley J. Katz O.D. 4355 24th Avenue, Suite 5 Fort Gratiot, MI 48059 (810) 385-4000

FRASER Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D. Michael J. Sistick O.D. 32925 Groesbeck Hwy. Fraser, MI 48026 (586) 293-8888

GARDEN CITY Elite Eyecare Centers


Andrew H. Schmitzer O.D. Daniel J. Trainor O.D. 6255 Inkster Road Suite 303 Garden City, MI 48135 (734) 261-6868

GRAND HAVEN

Rx Optical


Christine I Vandeweghe OD Amy L. Fitzgibbon O.D. 1125 S. Beacon Boulevard Grand Haven, MI 49417 (616) 846-4454

GRAND RAPIDS Rx Optical


Anthony W. Danko O.D. David G. Higley O.D. 5429 Northland Drive NE Grand Rapids, MI 49525 (616) 365-7600 Rx Optical


Sherah J. Eavey O.D. 3083 28th Street SE Grand Rapids, MI 49512 (616) 949-8974 Rx Optical


Sherah J. Eavey O.D. 4191 Plainfield Avenue NE Grand Rapids, MI 49525 (616) 364-8144 Rx Optical


Martha Romanyk O.D. 6749 Cascade Road Grand Rapids, MI 49546 (616) 957-3099

GRANDVILLE

Rx Optical


Amy L. Fitzgibbon O.D. Michael P. Jacquemin O.D. 4565 Wilson Avenue SW Grandville, MI 49418 (616) 531-7840

GROSSE POINTE Henry Ford Optimeyes

MMMAAATTTEEERRR IIIAAALLLSSS OOONNNLLLYYY

Henry Ford Medical Center 15401 E. Jefferson, 1st Floor Grosse Pointe Park, MI 48230 (313) 822-6000

Eye Works Optical


Angelo Tocco O.D. 20845 Mack Avenue (inside Grosse Pointe Eye Ctr.) Grosse Pointe Wds, MI 48236 (313) 885-4987

HASTINGS Rx Optical


Heidi M. Gordon O.D. 803 W. State Street Hastings, MI 49058 (269) 945-9724

HOLLAND

Rx Optical


Robert P. Arens O.D. Michael P. Jacquemin O.D. David G. Higley O.D. 1148 S. Washington Avenue Holland, MI 49423 (616) 396-8814

Rx Optical


Michael P. Jacquemin O.D. David G. Higley O.D. Amy L. Fitzgibbon O.D. Martha Romanyk O.D. 12659 Riley Street Holland, MI 49424 (616) 399-1440

IONIA

Rx Optical


Paul T. Lang O.D. 3125 S. State Street Ionia, MI 48846 (616) 527-9279

JACKSON

Rx Optical


Linda L. Goeman-Stahl O.D. 3132 E. Michigan Avenue Jackson, MI 49202 (517) 783-9000

Rx Optical


Linda L. Goeman-Stahl O.D. 1617 N. West Avenue Jackson, MI 49202 (517) 780-3828

JENISON Rx Optical


Stacy L. Maier O.D. Sherah J. Eavey O.D. 304 Baldwin Avenue Jenison, MI 49428 (616) 457-4443

JONESVILLE

Rx Optical


Joseph M. Hibler O.D. Matthew S. Haubert O.D. 855 Olds Street Jonesville, MI 49250 (517) 849-2200

KALAMAZOO

Rx Optical


Gerald E. Hanna O.D. 1700 S. Park Street Kalamazoo, MI 49001 (269) 342-3910

Rx Optical


Aaron J. Whitsett O.D. 5465 Gull Road Kalamazoo, MI 49004 (269) 349-7631

Rx Optical


Aaron J. Whitsett O.D. Gerald E. Hanna O.D. 125 S. Kalamazoo Mall Kalamazoo, MI 49007 (616) 342-0134

Rx Optical


Aaron J. Whitsett O.D. Karl K. Damm O.D. Kristina Swartz O.D. David C. McClintic O.D. 5349 W. Main Street Kalamazoo, MI 49009 (269) 349-7627 Rx Optical


Aaron J. Whitsett O.D. 601 John Street Suite 261 Kalamazoo, MI 49007 (269) 342-0003

KENTWOOD

Rx Optical


Amy L. Fitzgibbon O.D. 2350 44th Street SE Kentwood, MI 49508 (616) 281-1011

LAKE ORION



Stephanie B. Turpen O.D. Beverley J. Katz O.D. 684 S. Lapeer Road Lake Orion, MI 48362 (248) 693-3380


LANSING

Pearle Vision (Formerly D.O.C)


Marvin Matson O.D. 5224 S. Cedar Street Lansing, MI 48911 (517) 882-0202

Rx Optical


Paul T. Lang O.D. Leslie K. Delemeester O.D. 6001 W. Saginaw Hwy. Lansing, MI 48917 (517) 886-2888

Optiview Vision Center


Jack Adkins O.D. 635 S. Waverly Road Suite B Lansing, MI 48917 (517) 321-1041

LIVONIA

Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 37673 W. 5 Mile Road Livonia, MI 48154 (734) 464-4441

Royal Optics


Gary S. Yee O.D. 34393 Plymouth Road Livonia, MI 48150 (734) 522-6500



Howard J. Rosner O.D. 37339 Six Mile Road Livonia, MI 48152 (734) 591-5400

Michigan Eyecare Institute


Kevin J. Trapp O.D. 14555 Levan Livonia, MI 48154 (734) 464-7800

MADISON HEIGHTS



Kurt M. Schulz O.D. Beverley J. Katz O.D. 29351 John R Road Madison Heights, MI 48071 (248) 544-3290

MILFORD Henry Ford Optimeyes


Fariba M. Hickinson O.D. Anna Santillan O.D. Beverley J. Katz O.D. 516 Highland Avenue Milford, MI 48381 (248) 684-1229

MONROE

Best Vision / Eyecare One


Douglas W. Baltrip O.D. Kristy L. Watson O.D. 504 N. Telegraph Road Monroe, MI 48162 (734) 243-2020

MUSKEGON

Rx Optical


Ronald T. McClatchey O.D. Christine I Vandeweghe OD 2159 E. Apple Avenue Muskegon, MI 49442 (231) 767-1600

Rx Optical


Ronald T. McClatchey O.D. David G. Higley O.D. 1720 E. Sternberg Road Muskegon, MI 49444 (231) 798-7230

NILES

Rx Optical


Karl K. Damm O.D. Matthew S. Haubert O.D. 1421 S. 11th Street Niles, MI 49120 (269) 684-1330

OKEMOS Rx Optical


Leslie K. Delemeester O.D. 2285 W. Grand River Avenue Okemos, MI 48864 (517) 349-9944

OSCODA

Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D.

211 N. State Street Oscoda, MI 48750 (989) 739-2020

OWOSSO



Robert C. Hagemann O.D. Howard Foote O.D. Beverley J. Katz O.D. 1385 E. Main Street Owosso, MI 48867 (989) 725-7410

PLAINWELL

Rx Optical


Michael P. Jacquemin O.D. Robert P. Arens O.D. Heidi M. Gordon O.D. Aaron J. Whitsett O.D. 1281 West M-89 Plainwell, MI 49080 (269) 685-1071

PONTIAC

Lynn Optical Associates


Samuel M. Wapner O.D. 22 N. Telegraph Road Pontiac, MI 48341 (248) 332-2895

Optiview Vision Center


Angela Iceberg O.D. Frank Kozin O.D. 41 E. Walton Boulevard Pontiac, MI 48340 (248) 338-9115

PORTAGE

Rx Optical


David C. McClintic O.D. 6123 S. Westnedge Avenue Portage, MI 49002 (269) 327-7079

RICHMOND

Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D. Michael J. Sistick O.D. 66751 Gratiot Richmond, MI 48062 (586) 727-7555

ROCHESTER HILLS



John Gedda O.D. Spring Hill Plaza 2915 Walton Boulevard Rochester Hills, MI 48309 (248) 375-0022

Accent Eyecare (Optometry On The Mall)


Johnny Leung O.D. 2498 S. Rochester Road Rochester Hills, MI 48307 (248) 293-3399

ROCKFORD

Rx Optical


Anthony W. Danko O.D. Martha Romanyk O.D. 507 E. Division Street Rockford, MI 49341 (616) 866-3933

ROMEO

Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D. 71150 N. Van Dyke Road Romeo, MI 48065 (586) 752-9898

ROSEVILLE



Amy F. Jones O.D. Gregory C. Herbart O.D. Kristi A. Watchorn O.D. Ranald F. MacKenzie O.D. Xanthi Tuchowski O.D. Beverley J. Katz O.D. Roseville Super Vision Center 32600 Gratiot Avenue Roseville, MI 48066 (586) 294-0120

ST. CLAIR Distinctive Eyewear


Gary Kendrick O.D. 1315 Clinton Avenue Saint Clair, MI 48079 (810) 329-9725

ST. CLAIR SHORES Shore Optical


Mark Lavine O.D. 31503 Harper Avenue St Clair Shores, MI 48082 (586) 294-3080

ST. JOSEPH

Rx Optical


Andrea L. Bowmar O.D. Kristina R. Swartz O.D. 2008 Washington Avenue St Joseph, MI 49085 (269) 983-1303


SAGINAW

Riverfront Optical


Raymond Lalonde O.D. Paul Golsch O.D. Melissa David O.D. 3200 S. Cabaret Trail Saginaw, MI 48603 (989) 790-5005

SHELBY TOWNSHIP



Jerry Lebeau O.D. 50114 Van Dyke Avenue Shelby Township, MI 48317 (586) 726-5900

Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D. 51026 Van Dyke Ave Shelby Township, MI 48316 (586) 254-9620

SOUTH LYON

Oakland Vision


Fred E. Weiser O.D. 608 N. Lafayette Street South Lyon, MI 48178 (248) 437-3351

SOUTHFIELD



Kenneth Foon O.D. (inside Northland Mall) 21500 Northwestern Hwy. Southfield, MI 48075 (248) 559-3737 Black & White Look Optical


Myron J. Gerber O.D. 15675 W. Ten Mile Road Southfield, MI 48076 (248) 557-6444 Benjamin H Stein O.D.


Edward F. Stein O.D. 21500 Northwestern Hwy #635 Southield, MI 48075 (248) 569-2025



Frances Ceritano O.D. Beverley J. Katz O.D. 30800 Southfield Road Southfield, MI 48076 (248) 647-9790

Michigan Eyecare Institute


Kevin J. Trapp O.D. 29877 Telegraph Road Ste 100 Southfield, MI 48034 (248) 352-2806 Advance Eye Care M.D.


Lanny Green M.D. 23077 Greenfield Road Ste 144 Southfield, MI 48075 (248) 569-6120

SOUTHGATE Lesnick Optical


Barry K. Lesnick O.D. 13350 Fort Street Southgate, MI 48195 (734) 284-2020 Rx Optical


Natalie M. Sorce O.D. Matthew S. Haubert O.D. 19295 Eureka Road Southgate, MI 48195 (734) 282-9500 Henry Ford Optimeyes


Nathan D. Harris O.D. Shanna M. Voss O.D. Beverley J. Katz O.D. Southgate Super Vision Center 18900 Eureka Road Southgate, MI 48195 (734) 324-0996

STERLING HEIGHTS



Tatjana Ratzenberger O.D. William K. Carter O.D. Daniel L. Flick O.D. Beverley J. Katz O.D. Lakeside Super Vision Center 43910 Schoenherr Road Sterling Heights, MI 48313 (586) 247-5910 Henry Ford Optimeyes


Larry T. Olson O.D. Beverley J. Katz O.D. Henry Ford Medical Center 3500 15 Mile Road, 2nd Floor Sterling Heights, MI 48310 (586) 977-6403 Fraser Optical Inc.


Aimee K. Gray O.D. James G. Miller O.D. Mark A. Stefani O.D. Michael J. Sistick O.D. 3602 15 Mile Road Sterling Heights, MI 48310 (586) 977-9010

STURGIS

Rx Optical


Mark Prieur O.D. 500 S. Centerville Road Sturgis, MI 49091 (269) 651-1958

TAYLOR Optiview Vision Center


Frank Kozin O.D. 8212 S. Telegraph Road Taylor, MI 48180 (313) 291-7450 Oakland Eyewear

MMMAAATTTEEERRR IIIAAALLLSSS OOONNNLLLYYY

15055 Plaza South Drive Taylor, MI 48180 (734) 287-3663

THREE RIVERS

Rx Optical


Mark Prieur O.D. 111 S. US Hwy-131 Three Rivers, MI 49093 (269) 273-9515

TROY Golden Gate Optical


Asher L. Weisman O.D. Robert E. Brinker O.D. 2943 E. Big Beaver Road Troy, MI 48083 (248) 689-0213

WALKER Rx Optical


David G. Higley O.D. Aaron D. Miller O.D. 4335 Lake Michigan Drive Walker, MI 49504 (616) 791-6944

Rx Optical


David G. Higley O.D. Sherah J. Eavey O.D. 3576 Alpine Avenue NW Walker, MI 49504 (616) 784-4999

WALLED LAKE Oakland Vision Centers


Fred E. Weiser O.D. 519 N. Pontiac Trail Walled Lake, MI 48390 (248) 624-1707

WARREN



Anthony D. Spitler O.D. 26768 Dequindre Road Warren, MI 48091 (586) 751-3700

Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 3824 13 Mile Road Warren, MI 48092 (586) 751-2600

WATERFORD



Bradley D. Goldberg O.D. 4470 Highland Road Waterford, MI 48328 (248) 674-4065

WEST BLOOMFIELD



Robert V. Finlay O.D. Barry A. Bell O.D. Curtis E. Wee O.D. Rovetta Mattia O.D. Beverley J. Katz O.D. W. Bloomfield Super Vision Ctr. 6530 Farmington West Bloomfield, MI 48322 (248) 661-5100

WESTLAND Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 35675 Warren Avenue Westland, MI 48185 (734) 729-1411



Jay P. Lizyness O.D. Robert C. Hagemann O.D. Emily S. Michalik O.D. Margaret M. Kuznicki O.D. Bruce R. Wolffis O.D. Beverley J. Katz O.D. Westland Super Vision Center 35184 Central City Parkway Westland, MI 48185 (734) 427-5200

WOODHAVEN Rx Optical


Matthew S. Haubert O.D. 23110 Allen Road Woodhaven, MI 48183 (734) 676-4300


WYANDOTTE Wyandotte Optical


Dan Stein O.D. 3101 Biddle Avenue Wyandotte, MI 48192 (734) 282-5030

WYOMING

Rx Optical


Stacy L. Maier O.D. 1717 28th Street SW Wyoming, MI 49509 (616) 531-4370

YPSILANTI Fortney Eyecare Associates


William J. Fortney O.D. Christine A. Jack O.D. Alicia T. Zimnicki O.D. 2 N. Huron Street Ypsilanti, MI 48197 (734) 484-4400


Heritage Optical

If you would like to request a copy of our MemberRights and/or Notice of Privacy Practices, please con-tact us at:

Plan AdministratorHeritage Vision Plans, Inc.440 E. Congress, Suite 300Detroit, MI 48226Phone: (888) 322-0919Fax: (313) 863-5134Email: [email protected]

Provider Information

Information about any participating provider isavailable from Heritage Vision Plans at the above listed address.

Member R ights and Respons ib i l i t ies/ Pr ivacy Pract ices

Member Rights and Responsibilties

Non-Discrimination

Heritage Vision Plans does not discriminate on the basis of race, color, creed, national origin, residence within the approved service area, lawful occupation, sex, handicap, or marital status.

Members may be required to cooperate in the·subrogation and coordination of benefits.

Benefits may not be assigned.

Members shall notify their employer in case ofaddress change.

Members shall have the right to inspect and re-view their own medical records

·

·

·


DIFFERENT TYPES OF PRESCRIPTION LENSES


Based upon the particular eyesight disorder, different types of

Single Vision Lenses

corrective lenses are prescribed. As a rule, there are 4 types ofprescription lenses: Single Vision, Bifocal, Trifocal, and Progressive.

Single Vision lenses have only one viewing area throughout thelens. This corrected area can be for far distance, near distance, or reading.

Bifocal Lenses

Bifocals (meaning a lens with two points of focus, usually one

prescribed multi-focal lenses.

A small portion of the bifocal eyeglass lens is reserved for thenear-vision correction. The rest of the lens is usually a distance

for distance and one for near) are some of the most commonly

correction, but may have no correction at all if the wearer hasgood distance vision.

Trifocal Lenses

Trifocal lenses are lenses with three points of focus: usually fordistance, intermediate and near. Trifocals have an added seg-ment above the bifocal for viewing things in the intermediate

zone: about an arm's length away. Computer terminals are

typically in the intermediate zone.

Progressive Lenses

Progressive lenses correct vision for multiple distances without the visible segment lines seen in bifocal or trifocal lenses. Insteadthey have a graduated section in which the power of the lens

the wearer to see clearly at all distances.

progresses smoothly from one prescription to the other, allowing

Glossary of Eyewear Terms


The Eyewear Terms in this Glossary are provided for informational purposes only. They are not meant to reflect actual covered benefits under your vision plan.

Please refer to page 3, of this Handbook, for your covered benefits.


The Eyewear Terms in this Glossary are provided for informational purposes only. They are not meant to reflect actual covered benefits under your vision plan.

Please refer to page 3 of this Handbook for your covered benefits.

EYEGLASS LENS MATERIALS

Plastic remains the most popular lens material for eyeglasses in the

Plastic Lenses

United States, accounting for nearly 50% of all lenses sold. Plasticis generally regarded as the economy choice in lenses. It offers good optical clarity at a lower price point. Due to thickness, it isnot typically recommended for higher prescription powers.

Polycarbonate Lenses

Polycarbonate Lenses are the most durable of all lenses. Theselenses are over ten times more impact resistant than regular plastic.

eyewear (up to 40% thinner and 30% lighter than standard plasticlenses). Polycarbonate remains a good choice if you want the safest

and/or lightest lenses possible. It is also an excellent material choice

They are also one of the lightest, thinnest lens materials used in

Choosing the right lens material for your eyeglasses is animportant decision, and there are several options.

Hi Index lenses range from 20% to 65% thinner than plastic lenses prescriptions that want the thinnest, most attractive lenses possible.Hi Index lenses are an excellent alternative for patients with higher

(depending on the refractive index). The higher the refractive index,

The Trivex lens is a lightweight, impact resistant material much likepolycarbonate. It offers the added benefits of lower visual distortion, better optics, and inherent U.V. Protection. Trivex is a great substitute for polycarbonate lenses in prescription sunglasses because Trivexcan be easily tinted, whereas polycarbonate cannot.


Glossary of Eyewear Terms( c o n t i n u e d )

for children.

Trivex Lenses

the thinner the lens (and typically the higher the cost).

Hi Index Lenses

EYEGLASS LENS COATINGS AND OPTIONS

Plastic Lenses

of the lightest, thinnest lens materials used in eyewear (up to 40%

You'll likely be given different choices in eyeglass lens coatingsand other optical options. Here

The material in plastic lenses is relatively soft and is easily

Scratch Resistant Coating

scratched if it is not coated with scratch-resistant coating. Thiscoating, a much harder plastic compound, is applied to the lenssurface. The "Scratch Coat" greatly increases the lens' resistanceto scratches and abrasions, however it too can be scratched.

Anti-Reflective or AR Coating

Anti-Reflective Coatings help reduce the reflection on the lenses.When driving (day or night), or using the computer, they reduce the glare and lessen strain on the eyes. What you see is bothclearer and sharper. AR Coating also cosmetically enhances the lens, making the lens almost invisible. Your eyes, not the glasses, become the focus of attention.

Ultra-Violet or UV Coating

UV Coating helps protect the eyes from the harmful damagecaused by the sun. This protection helps the eyes tolerate bright sunlight and softens harsh light without making the glasses seem darker. (Note: Both Polycarbonate and Trivex lenses have built- in Ultra-Violet protective properties.)

Photochromic or Transitions Lenses

levels of sunlight. "Transitions" is the most well-known brand in the category of Photochromic lenses. When worn indoors they are " " virtually clear. When worn outside they change to a dark color.

Photochromic lenses change from light to dark through changing

" "

" "

There are many different choices in eyeglass lens coatings andother optical options. These coatings and options can enhancethe performance and appearance of your eyeglass lenses.

Glossary of Eyewear TermsGlossary of Eyewear Terms( c o n t i n u e d )

Polarized Lenses

Polarized Lenses block out virtually all Ultra-Violet Rays. Theselenses help to eliminate haze and glare, while increasing visibility.


Notes / Appoin tments

Heritage Optical 4

440 E. Congress, Suite 300 Detroit, MI 48226

1-888-252-2053 [email protected]

Member Services Center

(Revised: 03/12/2009)

Documents

Heritage Vision Benefit Summary & Directory - Wayne County