Vision Benefits
Administered by EyeMed Network- Insight
Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone. Members that choose Plus Providers enjoy additional benefit perks. You can find in network eye doctors – including PLUS Providers – on the Provider Locator at eyemed. com.
In-Network Member Cost At Plus Providers
In-Network( Member Cost)
Out-of-Network( Reimbursement)
Eye Exam— once every 12 months $ 0 copay $ 10 copay Up to $ 40 allowance Frames
Any available frame at provider location. Lenses
$ 0 copay: 20 % off balance over $ 180 allowance
$ 0 copay; 20 % off balance over $ 130 allowance
Up to $ 91 allowance
Single Vision Lenses $ 25 copay $ 25 copay Up to $ 30 allowance Bifocal Lenses $ 25 copay $ 25 copay Up to $ 50 allowance Trifocal Lenses $ 25 copay $ 25 copay Up to $ 70 allowance Lens Options UV Coating $ 15 $ 15 N / A Tint( Solid and Gradient) $ 15 $ 15 N / A Standard Plastic Scratch Coating $ 15 $ 15 N / A Standard Polycarbonate $ 40 $ 40 N / A Standard Anti-Reflective $ 45 $ 45 N / A Contacts
Conventional
Disposable
$ 0 copay: 15 % off balance over $ 130 allowance
$ 0 copay: 100 % of balance over $ 130 allowance
$ 0 copay; 15 % off balance over $ 130 allowance
$ 0 copay; 100 % of balance over $ 130 allowance
Up to $ 130 allowance
Up to $ 130 allowance
Medically Necessary $ 0 copay; paid in full $ 0 copay; paid in full Up to $ 300 allowance Frequency Examination Frames Lenses or Contact Lenses
For Lasik providers, call 877.5LASER6
Once every 12 months Once every 12 months Once every 12 months
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