Your Vision Coverage Options

We want to make caring for your eyes as simple as possible. And starting to take care of your vision now can go a long way towards keeping your eyes in shape for many years to come. Limited to $45 for EYE refraction exam. (Routine eye exam is limited to 1 every year, whether Network or Non-Network) Copay, Coinsurance, and Deductibles do not apply to EYE refraction exam. Hardware Copay, Coinsurance, & Deductible do not apply.

• Limited to $45 for EYE refraction exam. (Routine eye exam is limited to 1 every year, whether Network or Non-Network)
• Copay, Coinsurance, and Deductibles do not apply to EYE refraction exam.
• One pair per year whether Network or Non-Network.
• Single Vision: $28.80
• Bifocal, single: $48.60
• Bifocal, double: $88.20
• Trifocal: $70.20
• Aphakic – glass: $54.00
• Aphakic – plastic: $126.00
• Aphakic – aspheric: $162.00
• Frames – Network and Non-Network plan pays up to $45 (No Copay applies to this, the $45 is the benefit.)
• Contact Lenses – once per year, in lieu of frames & lenses.
• Medically necessary: $201.60
• Cosmetic: $50.40