Vision
This summary is an overview of your benefits only. Refer to your plan booklet for a complete description of benefits provided. The plan booklet and your eligibility for benefits will determine how your benefits are paid.
EyeMed Vision Plan
Benefit Highlights
In-Network
Exams
$10 Copay
Single Vision Lenses
$10 Copay
Bifocal Lenses
$10 Copay
Trifocal Lenses
$10 Copay
Frames
$130 Allowance; 20% discount off balance
Contacts (in lieu of glasses)
$110 Allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Up to $40 reimbursement
Single Vision Lenses
Up to $30 reimbursement
Bifocal Lenses
Up to $50 reimbursement
Trifocal Lenses
Up to $70 reimbursement
Frames
Up to $91 reimbursement
Contacts (in lieu of glasses)
Up to $110 reimbursement
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
