Vision Benefits
Additional Discounts:
40% OFF Complete pair of prescription eyeglasses
20% OFF Non-prescription sunglasses
20% OFF Remaining balance beyond plan coverage
(These discounts are for in-network providers only)
Take a sneak peek before enrolling:
• You’re on the INSIGHT Network
• For a complete list of in-network providers near you, use our Enhanced Provider Locator on www.eyemed.com or call 1-866-804-0982
• For Lasik providers, call 1-877-5LASER6
Vision Care Services |
In-Network Member Cost |
Out-of-Network Reimbursement |
|---|---|---|
Exam With Dilation as Necessary |
$10 Co-pay |
Up to $40 |
Retinal Imaging |
Up to $39 |
N/A |
Frames |
$0 Co-pay; $130 allowance; 20% off balance over $130 |
Up to $91 |
Standard Plastic Lenses |
||
Single Vision |
$25 Co-pay |
Up to $30 |
Bifocal |
$25 Co-pay |
Up to $50 |
Trifocal |
$25 Co-pay |
Up to $70 |
Standard Progressive Lens |
$90 Co-pay |
Up to $50 |
Premium Progressive Lens |
$110 Co-pay - $135 Co-pay |
|
Tier 1 |
$110 Co-pay |
Up to $50 |
Tier 2 |
$120 Co-pay |
Up to $50 |
Tier 3 |
$135 Co-pay |
Up to $50 |
Tier 4 |
$90 Co-pay, 80% of charge less $120 Allowance |
Up to $50 |
Lenticular |
$25 Co-pay |
Up to $70 |
Lens Options (paid by the member and added to the base price of the lens) |
||
UV Treatment |
$15 |
N/A |
Tint (Solid and Gradient) |
$15 |
N/A |
Standard Plastic Scratch Coating |
$15 |
N/A |
Standard Polycarbonate |
$40 |
N/A |
Standard Polycarbonate - Kids under 19 |
$40 |
N/A |
Standard Anti-Reflective Coating |
$45 |
N/A |
Premium Anti-Reflective Coating |
$57 - $68 |
N/A |
Tier 1 |
$57 |
N/A |
Tier 2 |
$68 |
N/A |
Tier 3 |
80% of charge |
N/A |
Photochromic/Transitions |
$75 |
N/A |
Polarized |
20% off retail price |
N/A |
Other Add-Ons and Services |
20% off retail price |
N/A |
Contact Lens Fit and Follow-Up (Contact lens fit and two follow up visits are available once a comprehensive eye exam has been completed) |
||
Standard Contact Lens Fit & Follow-Up |
Up to $55 |
N/A |
Premium Contact Lens Fit & Follow-Up |
10% off retail |
N/A |
Contact Lenses |
||
Conventional |
$0 Co-pay; $130 allowance; 15% off balance over $130 |
Up to $130 |
Disposable |
$0 Co-pay; $130 allowance; plus balance over $130 |
Up to $130 |
Medically Necessary |
$0 Co-pay, Paid-in-Full |
Up to $210 |
Laser Vision Correction |
||
Lasik or PRK from U.S. Laser Network |
15% off the retail price or 5% off the promotional price |
N/A |
Hearing Care |
||
Hearing Health Care from |
40% off hearing exams and a low price guarantee |
N/A |
Amplifon Hearing Network |
on discounted hearing aids |
N/A |
Frequency |
||
Examination |
Once every 12 months |
|
Lenses or Contact Lenses |
Once every 12 months |
|
Frames |
Once every 24 months |
Cost Per Pay Period |
|
|---|---|
Employee |
$3.18 |
Employee + Spouse |
$6.04 |
Employee + Child(ren) |
$6.36 |
Family |
$9.35 |