Malone Office Equipment
Vision Renewal
UNUM EyeMed
Insurance Carrier: Network:
In-Network
Out-of-Network
Exam Copay
$10 $40
up to $40
Contact Lens Exam Copay
N/A
Lenses - Single Lenses - Bifocal
$10 Copay $10 Copay $10 Copay $10 Copay
up to $30 up to $50 up to $70 up to $70
Lenses - Trifocal Lenses - Lenticular
$150 Retail Allowance, then 20% off remaining balance
up to $70
Frames
Elective Contact Lenses (in place of lenses & frame)
$150 Retail Allowance
up to $100
Medically Necessary Contacts
$0
Medically necessary up to $210
once every: 12 months / 12 months / 12 months
Frequency: Exam / Lenses / Frames Monthly Rates Employee Only Employee + Spouse Employee + Child(ren) Family
$7.35
$21.29 $13.56 $14.70
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