VISION PLAN
SUMMARY OF COVERAGE
In-Network
Out-of-Network
Eye Exams Covered Once Every 12 Months
$10 Copay
Up to $40 reimbursement
Frames Covered Once Every 24 Months
$150 Allowance + 30% discount on overage after $25 Copay
Up to $45 reimbursement
Lenses Covered Once Every 12 Months Contact Lenses (Medically Necessary) Covered Once Every 12 Months Contact Lenses (Elective) Covered Once Every 12 Months
$25 materials copay
Up to $80 reimbursement
Fitting/Evaluation: $40 Allowance Materials: $25 Copay Fitting/Evaluation: $40 Allowance Covered Plan Selection: $25 Copay Non-Plan Selection: $150 Allowance
Up to $210 reimbursement
Up to $125 reimbursement
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Hometown Veterinary Partners Benefits Guide
VISION PLAN
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