VISION

Vision benefits are so much more than an eye exam. They help you save money, stay healthy and see everything life has to offer.

The vision plan is administered by EyeMed. With this plan, you pay less when you visit a provider that participates in the EyeMed Select network. Importance of Eye Exams.

Highlights of the Plan

  • When you visit an EyeMed network provider, you pay a copay for eye exams and materials.
  • When you visit an out-of-network provider, you generally pay the provider directly and submit an itemized bill to EyeMed. You will receive reimbursement up to the scheduled amount for each covered service and supply.

Annual eye exams not only help correct vision problems, but comprehensive exams can also reveal the warning signs of more serious undiagnosed problems, such as high blood pressure, heart disease, and diabetes. The vision plan is administered by EyeMed. With this plan, you pay less when you visit a provider that participates in the EyeMed Select network.

For more information or to locate EyeMed vision providers, visit www.eyemedvisioncare.com or call 1-866-939-3633.

Vision Plans

Benefit EyeMed Option 1
In-Network Member Cost 		EyeMed Option 1
Out-of-Network Member Cost 		EyeMed Option 2
In-Network Member Cost 		EyeMed Option 2
Out-of-Network Member Cost
Exam (one every 12 months) $10 copay Up to $35 No copay Up to $28
Frames (one every 24 months) No copay; $120 allowance + 20% off balance over $120 Up to $48 No copay; $180 allowance + 20% off balance over $180 $90
Lenses (one every 12 months) Single Vision: $25 copay
Bifocal: $25 copay
Trifocal: $25 copay
 Single Vision: Up to $25
Bifocal: Up to $40
Trifocal: Up to $60 		No copay Single Vision: Up to $25
Bifocal: Up to $39
Trifocal: Up to $63
Contact Lenses (one order every 12 months) Conventional: No copay; $135 allowance + 15% balance over $135
Disposable: No copay; $135 allowance
Medically Necessary: No copay; Paid in Full
 Conventional: Up to $135 
Disposable: Up to $95
Medically Necessary: Up to $200 		Conventional: No copay; $180 allowance + 15% balance over $180
Disposable: No copay; $180 allowance
Medically Necessary: No copay; Paid in Full 		Conventional: Up to $144
Disposable: Up to $144
Medically Necessary: Up to $200