Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
EyeMed Vision
Plan Information
Plan Name: EyeMed Vision
Policy Number: #VC-146
Effective Date: 01/01/2025
Provider Network: Insight
Benefit Highlights
In-Network | Out-of-Network Reimbursement |
|---|---|
| Exams | Exams |
| $20 copay | Up to $40 reimbursement |
| Single Vision Lenses | Single Vision Lenses |
| $0 copay | Up to $30 reimbursement |
| Bifocal Lenses | Bifocal Lenses |
| $0 copay | Up to $50 reimbursement |
| Trifocal Lenses | Trifocal Lenses |
| $0 copay | Up to $70 reimbursement |
| Frames | Frames |
| $130 allowance (20% discount on balance over allowance) | Up to $91 reimbursement |
| Contacts (in lieu of glasses) | Contacts (in lieu of glasses) |
| Conventional: $130 allowance* Disposable: $130 allowance** Medically Necessary: $0 copay, paid in full | Conventional: Up to $91 Disposable: Up to $91 Medically Necessary: Up to $300 |
Frequency | Frequency |
|---|---|
| Exams | Exams |
| Once every plan year (1/1/2025 – 12/31/2025) | Once every plan year (1/1/2025 – 12/31/2025) |
| Lenses | Lenses |
| Once every plan year (1/1/2025 – 12/31/2025) | Once every plan year (1/1/2025 – 12/31/2025) |
| Frames | Frames |
| Once every plan year (1/1/2025 – 12/31/2025) | Once every plan year (1/1/2025 – 12/31/2025) |
| Contacts | Contacts |
| Once every plan year (1/1/2025 – 12/31/2025) | Once every plan year (1/1/2025 – 12/31/2025) |
*15% off balance over allowance
**100% off balance over allowance