EyeMed Essential: Lower premiums out of your paycheck each month, higher co-pays for some services when you purchase them.
Coverage Level | You pay |
---|---|
Employee only | $8.50 |
Employee + children | $15.20 |
Employee + spouse | $16 |
Employee + family | $21.40 |
Services have higher costs if you see an eye care provider outside the EyeMed network.
You can view the full Certificate of Coverage here.
Below is a breakdown of your costs when you visit eye care providers in the EyeMed network.
Summary of benefits | Your costs with EyeMed Essential |
---|---|
Vision services | |
Exam with dilation as necessary | $10 |
Laser vision correction | 85% of retail price or 95% of promotional price |
Glasses | |
Frames | 80 % of the charge minus a $130 allowance |
Single vision standard plastic lens | $10 |
Bifocal standard plastic lens | $10 |
Trifocal standard plastic lens | $10 |
Standard progressive lens | $75 |
Premium progressive lens-Tier 1 | $95 |
Premium progressive lens-Tier 2 | $105 |
Premium progressive lens-Tier 3 | $120 |
Premium progressive lens-Tier 4 | $75 co-pay, then 80% of the charge minus a $120 allowance |
UV treatment | $15 |
Tint (solid and gradient) | $15 |
Standard scratch resistance | $15 |
Standard polycarbonate (adults) | $40 |
Standard polycarbonate (children under 19) | $0 |
Standard anti-reflective coating | $45 |
Premium anti-reflective coating-Tier 1 | $57 |
Premium anti-reflective coating-Tier 2 | $68 |
Premium anti-reflective coating-Tier 3 | 80% of retail price |
Polarization, other add-on services | 80% of retail price |
Contact lenses | |
Standard contact lens exam | $40 |
Premium contact lens exam | 90% of retail price |
Conventional contact lenses | 15% off price after a $130 allowance |
Disposable contact lenses | Price minus a $130 allowance |
Medically necessary contact lenses | $0 |
EyeMed Enhanced: Higher premiums out of your paycheck each month, lower co-pays for some services when you purchase them.
Coverage Level | You pay |
---|---|
Employee only | $21.40 |
Employee + children | $38 |
Employee + spouse | $40 |
Employee + family | $53.60 |
Services have higher costs if you see an eye care provider outside the EyeMed network.
You can view the full Certificate of Coverage here.
Below is a breakdown of your costs when you visit eye care providers in the EyeMed network.
Summary of benefits | Your costs with EyeMed Enhanced |
---|---|
Vision services | |
Exam with dilation as necessary | $0 |
Laser vision correction | 85% of retail price or 95% of promotional price |
Glasses | |
Frames | 80 % of the charge minus a $160 allowance |
Single vision standard plastic lens | $10 |
Bifocal standard plastic lens | $10 |
Trifocal standard plastic lens | $10 |
Standard progressive lens | $10 |
Premium progressive lens-Tier 1 | $30 |
Premium progressive lens-Tier 2 | $40 |
Premium progressive lens-Tier 3 | $55 |
Premium progressive lens-Tier 4 | $10 co-pay, then 80% of the charge minus a $120 allowance |
UV treatment | $0 |
Tint (solid and gradient) | $0 |
Standard scratch resistance | $0 |
Standard polycarbonate (adults) | $0 |
Standard polycarbonate (children under 19) | $0 |
Standard anti-reflective coating | $0 |
Premium anti-reflective coating-Tier 1 | $12 |
Premium anti-reflective coating-Tier 2 | $23 |
Premium anti-reflective coating-Tier 3 | $80 percent of retail price minus a $45 allowance |
Polarization, other add-on services | 80% of retail price |
Contact lenses | |
Standard contact lens exam | $0 |
Premium contact lens exam | 90% of retail price minus a $40 allowance |
Conventional contact lenses | 15% off price after a $160 allowance |
Disposable contact lenses | Price minus a $160 allowance |
Medically necessary contact lenses | $0 |