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HumanaVision » EyeMed Plan » Optimum


 
Optimum
Vision care services See a participating provider See a nonparticipating provider
Exam with dilation as necessary $10 copay $30 allowance
Contact lens exam options*
Standard contact lens fit and follow-up Up to $40 not available
Premium contact lens fit and follow-up 10% off retail not available
Frames
Discounts available on all frames except when prohibited by the manufacturer. $130 allowance, 20% off balance over $130 $65 allowance
Standard plastic lenses
Single vision $0 copay $25 allowance
Bifocal $0 copay $40 allowance
Trifocal $0 copay $55 allowance
Lens options
UV coating $15 copay not available
Tint (solid and gradient) $15 copay not available
Standard scratch-resistance $15 copay not available
Standard polycarbonate** $40 copay not available
Standard anti-reflective coating $45 copay not available
Standard progressive (add-on to bifocal) $65 copay not available
Other add-ons and services 20% off retail price not available
Contact lenses (applies to materials only)
Conventional $130 allowance, 15% off balance over $130 $104 allowance
Disposable $130 allowance
$104 allowance
Medically necessary $0 copay, paid-in-full $200 allowance
Frequency
Examination Once every 12 months Once every 12 months
Frame Once every 24 months
Once every 24 months
Lenses or contact lenses Once every 12 months Once every 12 months

* Standard contact lens fitting: spherical clear contact lenses in conventional wear and planned replacement (examples include but not limited to disposable, frequent replacement, etc.)
Premium contact lens fitting: all lens designs, materials and specialty fittings other than standard contact lenses (examples include toric, multifocal, etc.)
** Standard polycarbonate available at no charge to dependents to 19 years old. All other members pay a fixed charge of $40.
© Humana Specialty Benefits 2008