Participating Optical Program  

The optical allowance of up to $80 every calendar year may be used at a Participating Optical Center selected by the Fund. The Centers agree to provide the following minimum services for the allowance:

  • EYE EXAMINATION - Including glaucoma testing for patients over 35

  • FRAMES - Any frame in the store with a retail value of up to $140

  • LENSES - All ranges of prescription lenses to be of first quality impact resistant glass or plastic, standard or oversized.  Polycarbonate lenses are covered for children who have not reached their 13th birthday.

  • LENS TYPES - Single, Bifocal (including generic  invisible or blended), Multifocal, Progressive (Silor Super/Progressive Elegance or equivalent), Daily, Extended and Disposable Contacts. (Cosmetic tinting not included - $80 allowance only for disposable lenses).

  • LENS TREATMENTS - Cosmetic and sun tinting, Scratch Resistance, Photosensitive (generic single and Flat Top 28 glass lenses only) and UV Protection.

The participating Fund optical providers have also agreed to the following set fees, which are the patient's responsibility:

MEMBER PAYMENT/SURCHARGES  

(Fees payable by the patient/member)

These charges are separate and are not to be construed as included in any other covered service or inclusive in another surcharge.  Frames selected outside the plan frames will have a $140 allowance subtracted from the retail value of the frame. 

 
   
Progressive (Varilux or equal)

 $75.00
Ultra Thin Lenses (Hi-Index)

 $60.00
Progressive Photosensitive Lenses (Generic or Equivalent) $110.00
Anti-Reflective Coating $30.00
Contacts, Disposable*

Balance after $80 Fund Payment
Sunsensitized Plastic Single Vision Lenses (including transitions)                                        $40.00
Sunsensitized Plastic Bifocal Lenses (Flat Top 28) including transitions                              $60.00
 
*You may not be denied your choice of disposable contact lenses if you choose not to agree to purchase further disposable lenses from the participating provider or the provider's recommended disposable lens supplier.

Refer to fee schedule for exam only benefit

 

Updated 05/18/04