Cigna Eyemed Vision
Benefits
In-Network
Out-of-Network
Eye Exam
$10 Copay
$45 Allowance
Materials
$25 Copay
n/a
Single Vision Lenses
$25 Copay
Plan pays up to $40
Bifocal Lenses
$25 Copay
Plan pays up to $65
Trifocal Lenses
$25 Copay
Plan pays up to $75
Lenticular Lenses
$25 Copay
Plan pays up to $100
$130 Allowance + 20% Off Balance
Frames
Plan pays up to $71
Contact Lenses Elective
$130 Allowance
Plan pays up to $105
Contact Lenses Medically Necessary
Covered in Full
Plan pays up to $210
Dependent Cut Off Age
26 Years Old
26 Years Old
Frequency is 1 per calendar year for exams, lenses, contact lenses and frames.
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