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 .
In Network ( Member Pays ) Out-of-Network ( Reimbursement ) Eye Exam — once every 12 months $ 10 copay Up to $ 40 allowance Frames Any available frame at provider location . $ 130 allowance ; 20 % off balance over $ 130 Up to $ 91 allowance Lenses Single Vision Lenses $ 25 copay Up to $ 30 allowance Bifocal Lenses $ 25 copay Up to $ 50 allowance Trifocal Lenses $ 25 copay Up to $ 70 allowance Lens Options UV Coating $ 15 copay N / a Tint ( Solid and Gradient ) $ 15 copay N / a Standard Plastic Scratch Coating $ 15 copay N / a Standard Polycarbonate $ 40 copay N / a Standard Anti-Reflective $ 45 copay N / a Contact Lens Fit and Follow-Up ( Contact lens fit and two follow-up visits are available once a comprehensive eye exam has been completed ) Standard Contact Lens Fit and Follow-Up Up to $ 55 N / a Premium Contact Lens Fit and Follow-Up 10 % off retail N / a Contacts Conventional $ 130 allowance ; 15 % off balance over $ 130 Up to $ 130 allowance Disposable $ 130 allowance ; plus balance over $ 130 Up to $ 130 allowance Medically Necessary Paid-in-full Up to $ 210 allowance Frequency Examination Frames Lenses or Contact Lenses
For Lasik providers , call 1.877.5LASER6
Once every 12 months Once every 12 months Once every 12 months
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