Vision Coverage
By practicing healthy eye habits, you and your family members can work towards preserving your vision for the long haul. Two Vision PPO plans are available through Anthem. As with a traditional PPO, you may take advantage of the highest level of benefit by receiving services from in-network vision providers and doctors. You may choose from many private practice doctors, local optical stores, and national retail stores including LensCrafters®, Target Optical®, Sears Optical® and JCPenney® Optical. You may also use your in-network benefits to order eyewear online at Glasses.com and ContactsDirect.com. To locate a participating network eye care doctor or location, log in at www.anthem.com/ca, or from the home page menu under Care, select Find a Doctor. You may also call member services for assistance at 1-866-723-0515. If you choose to, you may instead receive covered benefits outside of the Blue View Vision network . Just pay in full at the time of service, obtain an itemized receipt, and file a claim for reimbursement up to your maximum out-of-network allowance.
Blue View Low Plan In-Network (1 per 12 months) $10 copay (1 per 12 months) $10 copay (1 per 12 months)
Blue View High Plan In-Network (1 per 12 months) $10 copay (1 per 12 months) $10 copay (1 per 12 months)
Plan Highlights
Out-of-Network
(1 per 12 months) Up to $49
Annual Eye Exam Copay
Lenses ( Single Vision, Lined Bifocal, or Lined Trifocal) Contacts (in lieu of frame and lenses)
(1 per 12 months) Up to $35, $49, or $74
(1 per 12 months)
Conventional (non-disposable)
$130 allowance 15% off any remaining balance
$130 allowance 15% off any remaining balance.
Up to $92
Disposable
Up to $92
$130 allowance
$130 allowance
Medically Necessary
100% covered after copay 100% covered after copay
Up to $250
(1 per 24 months) $130 allowance; 20% off any amount over allowance
(1 per 12 months) $130 allowance; 20% off any amount over allowance
(1 per 24 months Low Plan) (1 per 12 months High Plan) Up to $50
Frames
Retinal Imaging
Not more than $39
Not more than $39
No discount
Additional Savings through Anthem Savings on items like additional eyewear after your benefits have been used, non- prescription sunglasses, hearing aids and even LASIK laser vision correction surgery are available through a variety of vendors. Log in at www.anthem.com/ca, select discounts, then Vision, Hearing & Dental. The above information is a summary only. Please refer to your Evidence of Coverage for complete details of benefits, limitations and exclusions.
14 Benefits Guide 2024-25
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