Vision Benefits
In-Network |
Frequency |
|
|---|---|---|
Exam |
$10 Copay |
Every calendar year |
Lenses |
$15 Copay |
Every calendar year |
Frames |
$200 retail max + 20% off balance over allowance |
Every calendar year |
Contact Lenses |
Medically Necessary: Fully covered after copay |
Every calendar year |
Dependent Age Limit |
26 |
Monthly Cost |
|
|---|---|
Employee |
$7.24 |
Employee + Spouse |
$14.48 |
Employee + Child(ren) |
$15.50 |
Family |
$24.77 |
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