Quick facts
Eye Exam Copay (In-Network)
$10 total copay for exam and/or glasses/necessary contact lenses ($0 at Premier Edge locations)
Frame Allowance
$250 Featured Frame Brand allowance (or $200 Standard frame allowance at in-network locations including Walmart/Sam's Club)
Elective Contact Lens Allowance
$150 allowance
Necessary Contact Lens Copay
$10 copay ($0 at Premier Edge Locations)
Contact Lens Exam (fitting/evaluation) Copay
up to $55 copay
Lenses Copay (included in total copay)
$10 (see eye exam total copay)
Out-of-Network Eye Exam Reimbursement
up to $45
Out-of-Network Frame Reimbursement
up to $47
More details (7)
Low Vision Coverage Max
Up to $1,000 maximum every two years
Self Only Rate (Bi-Weekly)
$6.72
Self Plus One Rate (Bi-Weekly)
$13.46
Self and Family Rate (Bi-Weekly)
$20.19
Self Only Rate (Monthly)
$14.56
Self Plus One Rate (Monthly)
$29.16
Self and Family Rate (Monthly)
$43.75
Carrier contact
800.807.0764 / TTY 711 — member services
Your member ID card: check the carrier website or app, or ask HR for a copy.
Plan documents
Confirm details with your carrier for current plan information.