Vision Care Benefits       Email   Print

Applies to All CHP Options
Not Applicable for Medicare Members

 
Administered by Vision Service Plan: 800-877-7195

2014 Benefits

Network Benefit Amounts:

Non-Network Reimbursement Amounts:

Eye Exam (one exam every calendar year)

100%, after $10 copay Up to $45
Prescription Glasses (lenses covered every calendar year) 

Single vision

100%, after $25 copay Up to $30
Progressive (no line) lenses 100%, after $25 copay Up to $50

Lined bifocal lenses

100%, after $25 copay Up to $50
Lined trifocal lenses 100% after $25 copay Up to $65
Lenticular lenses         100%, after $25 copay Up to $100

Frame (covered every other calendar year)

Up to $150 every two years, plus 20% off any out-of-pocket costs Up to $70
Contact Lenses (covered every calendar year)   

Elective Contact Lenses

$150 allowance applied to the cost of contact lenses and exam (fitting and evaluation). Up to $105

Medically Necessary Contact Lenses

Covered in full Up to $210
All services and related products must be received or purchased through Vision Service Plan. Note: Glasses and contact lenses will not both be covered by the plan in the same 12-month period. At least 12 months must separate the purchase of glasses and contact lenses in order for coverage to be provided for both.