• Single Vision; Bi-focal; Tri-focal; Lenticular: 100%
  • Frequencies (months) : Exam/Lens/Frames: 12/24/24
  • Progressive Lenses
    1. The member is responsible for the difference between the Covered Allowance and the Progressive Lens charge
  • Elective: Up to $150
  • Medically necessary: 100% covered
  • Photochromatic: glass/plastic: pays up to $30
  • Progressive Lenses: Plan pays up to $89.50
  • Polycarbonate Lenses: Plan pays up to $85
  • Tints: Pink & Rose covered in full