Vision Benefits
Vision insurance offers coverage for the routine care of your eyes and may provide coverage for eyeglasses and contact lenses.
Keep in mind that your costs will generally be lower if you choose an in-network eye-doctor. To find an in-network eye-doctor, please visit surency.com.
Insight Network |
Out-of-Network |
|
|---|---|---|
Routine Eye Exam |
$10 Copay |
$35 Reimbursement |
Frames |
$150 Allowance |
N/A |
Lenses |
||
Standard Plastic |
$25 Copay |
$25 Reimbursement |
Bifocal |
$25 Copay |
$40 Reimbursement |
Trifocal |
$25 Copay |
$55 Reimbursement |
Lenticular |
$25 Copay |
$55 Reimbursement |
Standard Progressive |
$90 |
$40 Reimbursement |
Premium Progressive |
Tier 1-$110/Tier 2-$120/Tier 3-$135/ |
$40 Reimbursement |
Contact Lenses |
||
Standard |
$40 Copay |
$0 Reimbursement |
Premium |
10% off retail |
$0 Reimbursement |
Conventional |
$150 Allowance; 15% off balance over $150 |
$90 Reimbursement |
Disposable |
$150 Allowance |
$90 Reimbursement |
Medically Necessary
|
$0 |
$200 Reimbursement |
Frequency |
||
Exams, Lenses & Contact Lenses |
Once every 12 months |
Once every 12 months |
Frames |
Once every 24 months |
Once every 24 months |
Monthly Cost |
|
|---|---|
Employee |
$6.73 |
Employee + Spouse |
$14.09 |
Employee + Child(ren) |
$12.08 |
Family |
$22.61 |