Vision Care Services | In Network |
Exam (w/ dilation as necessary) | $10 copay |
Frames | $0 Copay, $130 Allowance, 20% off balance over $130 |
Plastic Lenses | |
Single Vision Plastic Lenses |
$25 Copay |
Bifocal Plastic Lenses |
$25 Copay |
Contact Lenses |
|
Conventional Contact Lenses |
$0 Copay, $130 allowance, 15% off balance over $130 |
Disposable Contact Lenses | $0 Copay, $130 allowance, plus balance over $130 |
Medically Necessary Contact Lenses | $0 Copay, Paid-in-Full |
Laser Vision Correction | |
LASIK or PRK (From US Laser Network) | 15% off Retail Price or 5% off promotional price |
Frequency | |
Examination | Once every 12 months |
Lenses (In lieu of contact lenses.) | Once every 12 months |
Contacts (In lieu of lenses.) | Once every 12 months |
Frame | Once every 12 months |
Additional Discounts | |
Complete pair of prescription eyeglasses. | 40% OFF |
Non-prescription sunglasses. | 20% OFF |
Remaining balance beyond plan coverage. | 20% OFF |