Coverage for Exams - Frames - Lenses - Contact Lenses

Services Offered - All services are offered once in a 12 month period
Lifetime-Per Person Deductible of $65.00 on Frames and Contact Lenses ONLY!
Service Maximum Covered Expense
Examination—Includes case history; external examination of the eye and adnexa; ophthalmoscopic examination; determination of refracture status; binocular balance; tonometry test for glaucoma; gross visual field when indicated; summary finding; prescribing of lenses $45.00
Frames $65.00
Lenses (Per pair of lens-Patient pays remainder)  
Single $40.00
Bifocal $60.00
Trifocal $75.00
No line bifocal or progressive power OR Lenticular $80.00
Contact Lenses $110.00

 

Schedule of Benefits (Click Here)
Monthly Rates (Click Here)
Enrollment (Click Here)

 

Limitations and Exclusions on Vision coverage underwritten byAmeritas Group Dental and EyeCare:

Covered Expenses will not include and no benefits will be payable for expenses incurred for: 

  1. vision examinations more than once in any 12 month period

  2. prescribed lenses more than once in any 12 month period

  3. frames more than once in any 12 month period

  4. contact lenses more than once in any 12 month period.  When chosen, contact lenses shall be in lieu of any other lenses benefit during the 12 month period and in lieu of any other frame benefit during the 12 month period.  When lenses are    chosen, expenses for contact lenses are not Covered Expenses during the 12 month period

  5. examinations performed or frames or lenses ordered before the Insured was covered under this section

  6. subject to Extension of Benefits, any examination performed or frame or lens ordered after the Insured’s coverage under this section ceases

  7. sub-normal vision aids

  8. orthoptic or vision training or any associated testing

  9. non-prescription lenses; replacement or repair of lost or broken lenses or frames except at normal intervals

  10. any eye examination or corrective eye-wear required by an employer as a condition of employment

  11. medical or surgical treatment of the eyes; any service or supply not shown on the Schedule of Eye Care Services

  12. coated lenses; oversize lenses (exceeding 71 mm)

  13. photo-gray lenses; polished edges

  14. UV-400 coating and facets, and tints other than solid

  15. lenses and frames during the first 12 months that a person is insured under this section, when the person is a Late Entrant, as defined.