Vision Coverage
Your Vision Plan Options There are two Vision plans to choose from. 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 would be responsible for a co-payment at the time of your service. However, if you receive services from an out-of- network doctor, you may pay all expenses at the time of service and submit a claim for reimbursement up to the allowed amount. How To Find an In-network Provider You have many choices when it comes to using your benefits. 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, go to https://www.anthem.com/ca/find-care/ . You may also call member services 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
Blue View “High” Plan In-network
Out-of-Network Either Plan Reimbursed up to $49 Reimbursed up to $50 Low - Every 24 months High - Every 12 months
Plan Highlights
Exam - Every 12 months
$10 copay
$10 copay
$130 allowance and 20% off any amount over the allowance Every 24 months
$130 allowance and 20% off any amount over the allowance Every 12 months
Frames
Lenses (per pair) - Every 12 months
Single Vision
$10 copay
$10 copay
Reimbursed up to $35
Bifocal
$10 copay
$10 copay
Reimbursed up to $49
Trifocal
$10 copay
$10 copay
Reimbursed up to $74
Contacts (In lieu of glasses) - Every 12 months Conventional (non-disposable)
$130 allowance and 15% off any amount over the allowance
$130 allowance and 15% off any amount over the allowance
$130 allowance and 15% off any amount over the allowance
Disposable
$130 allowance
$130 allowance
$130 allowance
Medically Necessary
100% covered after $10
100% covered after $10
Reimbursed up to $250
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. https://www.anthem.com/ca/member- resources/wellness-programs. The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions.
14 Benefits Guide 2025-26
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