The benefits described in this section apply to Members up to age 71 and their eligible Dependents. Following a description of the benefits covered, you will find a description of how and when to file claims for these benefits.
All lenses must be prescribed by an Optometrist or an Ophthalmologist and must be for the correction of visual defects.
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Eye Wear
Laser Eye Surgery Visual Training by
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One pair of prescribed frames & lenses (including bifocals, hardex, and tints one (1) and two (2)), or contact lenses (including disposables), or sunglasses, or safety glasses (for members only, excludes dependents). Up to $500.00 once every 24 months for adults, and once every 12 months for children under age 18. Includes one eye exam to a maximum of $50.00 once every 24 months for adults between the ages of 20 and 64. 50% up to $1,000.00 per lifetime. Members are encouraged to research the credentials and experience of the laser eye surgeons before selecting their service provider. $100.00 once every 12 months.
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The purpose of the Vision Care benefit is to help meet actual expenses. Benefits under this plan will be coordinated with any benefits received under other plans, in order that you will not receive more than your actual expenses.
The Co-ordination of Benefits provision described on this site will apply.
Exclusions
The following expenses will not be reimbursed:
- Treatment furnished without charge or paid directly or indirectly by any government or for which a government prohibits payment of benefits.
- Services and supplies received principally for cosmetic purposes.
- Artificial eyes, anti-reflective coatings or for any tint (except tints one (1) and two (2), as detailed above). Please note that artificial eyes may be covered under the Durable Medical provisions of the Extended Health Care Benefit.
- Replacement of any eye wear, due to loss, breakage or theft.
Proof of Loss
Written proof stating the occurrence, character and extent of loss must be submitted to the Administrative Agent within 12 months after the date of the loss, but not more than 3 months after the date coverage terminates, for Vision Care Benefits.