Cigna Vision The Schedule
For You and Your Dependents Allowance The maximum amount Cigna will pay each Covered Person per Calendar Year, the member is responsible for any amount over the allowance. Copayments Copayments are amounts to be paid by you or your Dependent for covered services. Calendar Year The term Calendar Year means the period that begins on January 1st and ends on December 31st of that year.
IN-NETWORK **
OUT-OF-NETWORK
BENEFIT HIGHLIGHTS
BENEFIT HIGHLIGHTS
The Plan will pay 100% after any Copayment or Coinsurance,
The Plan will reimburse you at 100%, subject to any maximum Allowance shown below
subject to any maximum Allowance shown below
EXAMINATION(S): Comprehensive Examination One Eye Exam every Calendar Year
$10 Copayment
$45
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