EyeMed Vision Fee Schedule

Vision Care Services

Member Cost

Exam with Dilation as Necessary:

$50

Standard Contact Lens Fit & Follow-up:

$10 off Standard Fee

Complete Pair of Glasses Purchase*:  frame, lenses and lens options must be purchased in the same

            transaction to receive full discount.

Standard Plastic Lenses (Includes Scratch Resistant Coating):   

          Single Vision - Adult

$55

          Single Vision - Dependents up to 19 (includes Polycarbonate)

$55

          Bifocal

$75

          Trifocal

$85

          Standard Progressive

$140

          Premium Progressive

30% off retail price

     Frames:

     Any frame available at provider location

 40% off retail price up to $140, then 20% off balance

     Lens Options:

          UV Coating

$12

          Tint (Solid and Gradient)

$12

          Standard Polycarbonate

$35

          Standard Anti-Reflective Coating   

$40

          Other Add-Ons and Services

30% off retail price

Contact Lens Materials:

(Discount applied to materials only)

 Disposable   

0% off retail price

 Conventional

15% off retail price

Laser Vision Correction**:

       Lasik or PRK

15% off retail price - or -

5% off promotional price

Frequency:

         Examination

Unlimited

         Frame

Unlimited

         Lenses

Unlimited

       Contact Lenses

Unlimited

*Items purchased separately will be discounted 20% off of the retail price.

THIS IS NOT INSURANCE

**Members also receive 15% off retail price or 5% off promotional price for Lasik or PRK from the US Laser Network, owned and operated by LCA vision.  Since Lasik or PRK vision correction is an elective procedure, performed by specially trained providers, this discount may not always be available from a provider in your immediate location.  For a location near you and the discount authorization please call 1-877-5LASER6.

When purchasing a complete pair, members will receive a 30% discount on those items purchased at participating Providers that are not specifically covered by this Discount design.  The 30% discount may not be combined with any other disocunts or promotional offers, and the discount does not apply to EyeMed Provider's professional services, or contact lenses.  Retail prices may vary by location.

Limitations/ Exclusions:

· Orthoptic or vision training, subnormal vision aids, and any associated supplemental testing

· Medical and/or surgical treatment of the eye, eyes, or supporting structures

·Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan

· Services provided as a result of any Worker's Compensation law

· Discount is not available on those frames where the manufacturer prohibits a discount