VISION INSURANCE
Kisinger Campo & Associates offers vision coverage through Advantica. The Advantica vision plan allows you the flexibility to see any provider. To search in-network providers go to www.AdvanticaBenefits.com and search under “future member”. For out-of-network claims you pay expenses at the time of service and file a claim for reimbursement. Below is a list of the reimbursement schedule.
Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.
Vision
Out-of-Network 1
In-Network
Routine Eye Exams
Every __ months
$__ Copay
Reimbursed up to $
Lenses 2
Every __ months
Single Vision Bifocal Trifocal Lenticular
Reimbursed up to $__, depending on type of lenses
$__ Copay
Frames
Every __ months
$__ Copay provides, $ Allowance PLUS __% off cost over the allowance
Reimbursed up to $
Contact Lenses (in lieu of glasses)
Every __ months
Elective Contact Lenses Preferred Non-Preferred
$__ Copay provides you a $ allowance $__ Copay provides you $ allowance
Reimbursed up to $
Medically Necessary
$__ Copay
Reimbursed up to $
Cost of coverage per paycheck
Employee only
$
$
Employee + Spouse
$
$
Employee + Child(ren)
$
$
Employee + Family
$
$
1 Reimbursable amount, less applicable copay.
2 Lenses benefit listed are for a pair of lenses.
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