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VISION

VISION

  • Choose an Anthem Blue View Vision network eye care provider at www.anthem.com
  • Vision examinations are covered once every calendar year
  • Prescription lenses are covered once every calendar year
  • Frames are covered once every two calendar years
  • Prescription contact lenses are covered once every calendar year
Resources

Carrier:
Anthem Blue View Vision
Policy Number: W42719
Customer Service:
1-866-723-0515
Website: www.anthem.com

Covered Benefits | Blue View Vision Base Options Buy-Up
Vision Examination
including dilation and refraction as needed. Covered once every calendar year
$20 copayment $10 copayment
Prescription Lenses
(Pair) Standard plastic lenses up to 55 mm; and all ranges of prescriptions
Covered once every calendar year
Basic Lenses (Pair)
Bifocal Lenses (pair)
Trifocal Lenses (Pair)
$20 copayment $10 copayment
Frames
Covered once every two calendar years for the base option and once every calendar year for the buy-up option
No copayment, up to $130 retail value No copayment, up to $150 retail value
Prescription Contact Lenses*
Covered once every calendar year
Contact Lenses (elective) (in lieu of eyeglasses lenses allowances)
Conventional Contact Lenses
Disposable Contact Lenses
Contact Lenses (non-elective)
No copayment, up to $130 retail value No copayment, up to $150 retail value
Lens Options Member Cost for Upgrades
UV Coating
Tint (Solid & Gradient)
Standard Scratch-Resistance
Standard Polycarbonate
Standard Progressive (Add-on to bifocal cost)
Standard Anti-Reflective Coating
Other Add-on Services
Transition Lenses
$15
$15
$15
$40
$65
$45
20% off retail
$75

* From the last date of service
** Professional fitting fees are not a covered service but may be covered or partially covered by applying any remaining contact lens allowance unused for the materials (lens) purchase. Any remaining amount will be applied to the professional fitting fee of the prescribing provider. Contact lens allowance must be used at one time; no amount will be carried forward. If the insured person chooses conventional contact lenses greater than the plan allowance, the insured person will receive a 15% discount toward the difference. If the insured person chooses disposable lenses greater than the plan allowance, the insured person is responsible for the balance.
*** Items purchased separately are discounted 20% off the retail price.

Employee Payroll Contributions
 
  Base Plan Buy-Up Plan
  Weekly Bi-Weekly  Weekly Bi-Weekly 
Employee $1.44 $2.89 $1.89 $3.78
Employee + Spouse $2.53 $5.06 $3.32 $6.63
Employee + Child(ren) $2.89 $5.78 $3.79 $7.57
Family $5.42 $10.85 $7.11 $14.21