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.
Anthem Vision PPO
Benefit Highlights
In-Network
Exam
$10 copay
Materials
$25 copay
Single Vision Lenses
$0 after materials copay
Bifocal Lenses
$0 after materials copay
Trifocal Lenses
$0 after materials copay
Frames
$130 limit, then 20% off remaining balance
Contacts (in lieu of glasses)
$130 limit
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exam
Up to $42
Materials
Up to plan allowance
Single Vision Lenses
Up to $40
Bifocal Lenses
Up to $60
Trifocal Lenses
Up to $80
Frames
Up to $45
Contacts (in lieu of glasses)
Up to $105
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Semi-Monthly Plan Cost
Employee Only: $1.50
Employee and Spouse/DP: $3.00
Employee and Child(ren): $3.00
Employee and Family: $4.50
