AMIkids Open Enrollment 2017-18

VISION INSURANCE

AMIkids offers vision coverage through Blue Cross Blue Shield (Blue Cross Blue Shield). The Blue Cross Blue Shield vision plan provides you access to the EyeMed network and allows you the flexibility to see any provider, to maximize savings seek services from a EyeMed network provider. If you utilize an out-of-network provider, you’ll pay expenses at the time of service and file a claim for reimbursement. The chart below provides a brief overview of the plan and reimbursement schedule for out- of-network services. AMIkids has not raised Vision Plan premiums for FOUR years!

Your vision is important to your health. Whether your vision is 20/20 or less than perfect, everyone should receive regular vision care.

To find in-network providers visit www.MyHealthToolkitFL.com and hover over on the “Education Center” in the top menu and click on “Enrollment Tools”. Under Healthy Vision you will find a link for “EyeMed Provider Locator”. Get results by entering your location and select the “Access” network.

Vision EyeMed Access Network

Out-of-Network 1

In-Network

Routine Eye Exams

Every 12 months

$20 Copay

Reimbursed up to $35

Lenses 2

Every 12 months

Single Vision Bifocal Trifocal Lenticular

$40 Copay (no cost scratch coating)

Reimbursed $25-$55, depending on type of lenses

Frames

Every 12 months

$40 Copay provides, $130 Allowance PLUS 20% off cost over the allowance

Reimbursed up to $65

Contact Lenses (in lieu of glasses)

Every 12 months

Elective Contact Lenses Conventional

$40 Copay provides, $200 allowance PLUS 15% off cost over the allowance

Reimbursed up to $160

Disposable

$40 Copay provides, $200 allowance

Medically Necessary

Covered in full

Reimbursed up to $210

1 Reimbursable amount, less applicable copay . 2 Lenses benefit listed are for a pair of lenses.

Cost for Coverage Amounts shown are per pay check ( 24 payments/year )

Vision Plan

Employee Only

$ 3.74 $ 7.70 $ 6.50 $10.46

EE

Employee + Spouse

ES

Employee + Child(ren)

EC

Employee + Family

FAM

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