State of Texas Vision covers one eye exam per covered person per plan year, contact lens fitting and other eyewear and contact lens options. Benefits include an allowance that can be used toward the purchase of either eyeglass frames or contact lenses. See details about covered services in your State of Texas Vision Member Handbook or view benefits and resources on the State of Texas Vision website.
Active employees and retirees not enrolled in Medicare can enroll in State of Texas Vision during Summer Enrollment or within 31 days of a qualifying life event (QLE). Medicare-eligible retirees can enroll during their annual Fall Enrollment period or within 31 days of a QLE.
There is no waiting period. Coverage for new employees begins during their first month of employment. Coverage for active employees who sign up during Summer Enrollment begins September 1; coverage for Medicare-enrolled retirees who sign up during Fall Enrollment begins January 1.
You will receive one ID card in the mail for you and any covered dependents. You can download additional copies of your card or review your benefits when you create a State of Texas Vision online account. You also may request additional cards by calling Superior Vision Customer Service at (877) 396-4128.
If your current eye care professional is not listed, you can request that they be added to the network by submitting a provider nomination form or by calling Superior Vision Customer Service at (877) 396-4128. The credentialing process can take up to 60 days.
Yes. If you go to an out-of-network provider, you are responsible for submitting a Member Reimbursement Claim Form and a detailed receipt. You will receive the out-of-network reimbursement detailed in your Member Handbook.
Yes, you may choose the provider that matches your needs and preferences. Each provider will contact Superior Vision to verify your eligibility.
The State of Texas Vision network includes thousands of providers and the country's top 50 retail chains, such as:
- 1-800 Contacts
- America’s Best Contacts & Eyeglasses
- Costco Optical
- Eyemart Express
- Eyeglass World
- Pearle Vision
- Sam's Club Optical
- Target Optical
- Texas State Optical (TSO)
- Walmart Vision Center
Note: Prior to your appointment, please call ahead to confirm services, discounts and acceptance of your vision plan with your selected provider. Providers may practice at multiple locations and not all locations may be contracted as in-network. A provider’s participation status is subject to change.
Network providers are available in all 50 states. Visit the State of Texas Vision website for a list of network providers.
A network provider will submit the claim for you. If you use a non-network provider, you must file a claim for reimbursement. Superior Vision generally mails reimbursements within 10 business days of receipt to the address you have on file with ERS.
You are responsible for paying all copays, as well as non-covered items and/or any amount over the benefit allowance. You will pay your provider at the time of service.
The $200 allowance can be applied to either frames OR contact lenses. You are responsible for any costs above the $200 allowance. Network providers and online distributors offer discounts for eyeglass lenses, coatings and tinting. See details in the State of Texas Vision Member Handbook.
Yes, the contact lens fitting is a separate evaluation and is a stand-alone benefit requiring an additional copay of $25 or $35 depending on your needs. Details are available in your Member Handbook.
Dilation is not always necessary in an eye exam, but is covered when recommended by an eye care provider. Retinal imaging, digital retinal exams and fundus photography are not covered and you will be responsible for the charges. See the Member Handbook for details.
No. For glaucoma treatment and other diseases of the eye, you will need to use the coverage offered through your health plan. Consult your health plan provider for questions about medical coverage.
Medically necessary lenses are prescribed for patients whose vision cannot be corrected with eyeglasses. Contact lenses that are chosen as an alternative to glasses for vision correction are considered cosmetic. Contact Superior Vision if you have questions about whether your prescription is considered medically necessary.
You can apply the $200 allowance to prescription sunglasses. It is not available for non-prescription sunglasses. Find cost information about add-ons such as scratch-resistant coating in the Member Handbook.
LASIK is not a covered benefit. Some providers offer LASIK discounts to State of Texas Vision participants.
If your claim is denied, call or write Superior Vision to request an explanation. To appeal the decision, you must submit your appeal in writing. ERS will examine your appeal and notify you about the status of your claim.
To file a complaint against a provider, contact Superior Vision at (877) 396-4128 (TDD: 711) toll free.
Yes. A TexFlex health care flexible spending account (FSA) or limited-purpose flexible spending account (Consumer Directed HealthSelectSM participants only) lets you set aside pre-tax income to pay for eligible dental and vision expenses for you and your dependents. See the TexFlex website for more information and a list of eligible expenses for each type of spending account. The TexFlex program is available to benefits-eligible active employees.
No, an improvement in vision is not considered a qualifying life event. You would continue to pay the premiums for the remainder of the plan year until the next open enrollment period or qualifying life event.
After you leave employment, you may be eligible to continue coverage under COBRA for up to 18 months by paying your premiums directly to ERS. COBRA is limited to the benefits you had when you left employment. If you choose COBRA continuation coverage, you will pay the full cost of your premium(s).