Vision
Annual vision exams are an important part of managing your overall health.
Vision exams can help to identify certain medical conditions such as diabetes or high cholesterol. To help you manage your health, we offer vision coverage through Sample Provider. Under this plan, you may use the eye care professional of your choice.
When you use a participating network provider, you receive higher levels of coverage.
Vision Coverage Plan Summary
| Sample Vision Vendor | ||
|---|---|---|
| In-Network | Out-of-Network | |
| Cost | $X copay | Up to $X reimbursement |
| Benefit Frequency | ||
| Exams | Once per XX months | |
| Lenses | Once per XX months | |
| Frames | Once per XX months | |
| Contacts (In lieu of glasses) | Once per XX months | |
| Covered Services | ||
| Single Lenses | $XX copay | Up to $X reimbursement |
| Bifocals | $XX copay | Up to $X reimbursement |
| Trifocals | $XX copay | Up to $X reimbursement |
| Frames | Up to $XX allowance + X% discount | Up to $X reimbursement |
| Contacts (Medically Necessary) | Up to $XX | Up to $X reimbursement |
| Contacts (Elective) | Up to $XX allowance | Up to $X reimbursement |