Vision
The vision plan allows you to utilize both in-network and out-of-network providers. However, you will receive maximum value from your vision benefits when you choose network providers. If you go out-of-network, you will be reimbursed up to the plan’s out-of-network allowance.
The plan pays benefits for both in-network and out-of-network services. However, you will receive maximum value from your vision benefits when you choose network providers.
Vision Plan Overview + Contributions
| EYEMED VISION | ||
| Vision Plan Highlights | In-Network | Out-of-Network Reimbursements |
| Vision Exam | $20 Copay | Up to $30 |
| Materials (Lenses & Frames OR Contact in Lieu of Glasses) | ||
| Lenses for Eyewear (Once every 12 months) Single / Bifocal / Trifocal | $20 Copay | Up to $25 / $40 / $60 |
| Frames (Once every 12 months) For frames that exceed your allowance, you may receive an additional 20% discount on the overage. | No Copay, up to $150 allowance, 20% discount off balance over $150 | Up to $75 |
| Contact Lenses (Once every 12 months) | ||
| Conventional | No Copay, Covered up to $180, 15% discount off overage | Up to $144 |
| Disposable | No Copay, Covered up to $180 | Up to $144 |
| Medically Necessary | No Copay, Covered in Full | Up to $300 |
| Dependent Age Limit | To Age 26 | |
| NOTE: This chart does not describe all covered services. Please review the plan summaries for complete coverage information. | ||
Employee Vision Contributions (24 times per plan year)
| EYEMED | VISION | |
| EMPLOYEE | EMPLOYER | |
| Employee | $1.83 | $0.47 |
| Employee + Child(ren) | $3.31 | $0.82 |
Savings & Finance
Voluntary Benefits