Claiming sunglasses under the PSHCP’s Vision Care Benefit

July 17, 2017

With summer in full swing, an increasing amount of members are submitting claims for eyeglasses, including sunglasses, under the Public Service Health Care Plan (PSHCP). Under the Vision Care Benefit, a maximum eligible expense of $275, reimbursed at 80%, is available to members for the purchase or repairs of eyeglasses necessary for the correction of vision.

Eligible expenses are the reasonable and customary charges for eyeglasses and contact lenses prescribed by an ophthalmologist or optometrist. Expenses claimed under the Vision Care Benefit are subject to a two-year eligibility cycle that begins every odd year. A new cycle began in 2017, and the next will begin in 2019.

Expenses incurred for eyeglasses, sunglasses or contact lenses not used for the correction of vision are ineligible under the terms of the Plan. While the PSHCP does not specifically define “correction of vision,” the Vision Care Benefit is administered based on the common interpretation of vision correction, which is generally defined as one of several methods used to improve blurred vision caused by refractive error, such as nearsightedness or farsightedness.

To learn more about the PSHCP’s Vision Care Benefit, click here.