Anthem Blue View Vision
866-723-0515
Group Number: 175028
Employees and their eligible dependents may enroll in the Anthem Blue View Vision PPO Plan (EyeMed). This plan is designed to encourage members to maintain their vision through regular eye examinations and help with vision care expenses for required glasses and contact lenses. members may take advantage of the highest level of benefits by receiving services from in-network vision providers.
Anthem Blue View Vision Plan Highlights | IN-NETWORK | OUT-OF-NETWORK |
|---|---|---|
General Plan Information | When you obtain vision services from Anthem Blue View Vision providers, you will receive a higher level of coverage. | You may receive vision care from any doctor you wish. If you receive care from non-Anthem Blue View Vision doctors your coinsurance will be higher. |
Examination Copay | $20 | $45 |
Vision Examination | Once Every 12 Months Covered up to a comprehensive examination | |
Covered at 100% | Covered to a Maximum of $45 | |
Frames | Once Every 12 Months | |
Covered at 100% | Covered to a Maximum of $47 | |
Lenses | Once Every 12 Months | |
Single Vision (Pair) | Covered at 100% | $45 |
Bifocal Lenses (Pair) | Covered at 100% | $65 |
Trifocal Lenses (Pair) | Covered at 100% | $85 |
Progressive Lenses (Pair) | Covered at 100% | Not Covered |
Contact Lenses | 12 Months | |
Medically Necessary | Covered at 100% | Covered to a Maximum of $210 |
Cosmetic | Covered to a Maximum of $120 in lieu of Frames and Lenses | Covered to a Maximum of $105 in lieu of Frames and Lenses |
