Vision

General Vision Service Plan

Poughkeepsie Public School Teachers Active & Retirees Members/Account 8600/8700

You and your family are are entitled to the following vision benefits once every School year between September 1 and Aug 31:

There is no deductible or co-pays applied when you stay within your POUGHKEEPSIE PUBLIC SCHOOL TEACHERS benefit plan and the GENERAL VISION COLLECTION/NETWORK.

family

Benefits include:

Comprehensive Eye Examination

Selection of Various Frames: Up to a retail value of $200.00 (Within the GVS Collection).

  • Selection of lens in plastic:
  • Single Vision
  • Conventional Bifocals
  • Conventional Trifocals
  • GVS Progressives Cosmetic & Rx Sun Tints included.
  • Contacts
  • Standard Soft Spherical Daily Wear
  • Extended Wear Spherical Lenses
  • A 6-month supply (4 boxes) of basic disposables are included. For any other contacts, patient will pay U&C retail less $200.

The following are special surcharges for services not included in this plan:


  • AR Coating: $35
  • Polycarb SV: Included in Rx only
  • Polycarb FT28: $80
  • GVS Progressives: $30
  • Premium Progressives: $70
  • Varilux Comfort: $120
  • 1.60 High Index SV: $70
  • 1.60 High Index FT28: $110
  • Transitions 3 SV: $80
  • Transitions 3 FT28: $150
  • Trans High Index SV: $115
  • Trans High Index FT 28: $125
  • Loss/Broken Protection Plan: $25

  • Is included with a 25.00 co-pay at time of loss for what is covered within your program only if you go to a participating provider.
  • Note: Any frame over $200, patient pays U&C retail less $200, less 30%. All other upgrades not listed, patient pays U&C retail less 30%. Members can receive an eye examination from a non-par provider and go in-network to a GVS provider to fulfill prescription.
Note: Any frame over $200, patient pays U&C retail less $200, less 30%. All other upgrades not listed, patient pays U&C retail less 30%. Members can receive an eye examination from a non-par provider and go in-network to a GVS provider to fulfill prescription.

Option #2
Out of Network Benefits


Members within this group has the option of going out-of-network using the following out-of-network benefits if member is eligible:

  • Exam fee: $50
  • Frames only: $100
  • Single Vision only: $50
  • Bifocal/Trifocal Additiona:l $60
  • Contacts Complete: $150
  • Lasik Surgery: $500.00 per eye

Vision Benefits Link

Note: Benefit will be reimbursed to the member after receiving an authorization number and returning the appropriate claim form and receipts.
Loss/Broken Protection Plan is included with a 25.00 co-pay at time of loss for what is covered within your program if you go to a participating provider.