Vision Coverage
Keep your vision clear and your eyes in good health with regular eye exams. Your medical plans include basic vision through
EyeMed at no additional cost to you. You may elect to enroll in the EyeMed Vision Enhanced plan which includes increased
benefit coverage at a low monthly cost. The benefits vary based on the plan you choose. Find a vision provider online at www.eyemed.com.
| Plan | EyeMed Vision Basic | EyeMed Vision Enhanced | ||||
|---|---|---|---|---|---|---|
| Exam with dilation as necessary (once per plan year) |
$25 copay | $10 copay | ||||
| Frames (once per plan year) |
$0 copay, $130 allowance, 20% off balance over allowance |
$0 copay, $225 allowance, 20% off balance over allowance |
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| Lenses (once per plan year) | ||||||
| Single Vision | $25 copay | $25 copay | ||||
| Bifocal | $25 copay | $25 copay | ||||
| Trifocal | $25 copay | $25 copay | ||||
| Lenticular | $25 copay | $25 copay | ||||
| Contact Lenses (once per plan year in lieu of lenses) | ||||||
| Conventional | $0 copay, $130 allowance, 15% off balance over allowance |
$0 copay, $225 allowance, 15% off balance over allowance |
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| Disposable | $0 copay plus balance over $130 allowance |
$0 copay plus balance over $225 allowance |
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| Medically Necessary | $0 copay, paid in full | $0 copay, paid in full | ||||
