Page Scrantom - 2024 Benefits Guide

Vision Coverage

The vision plan covers routine eye exams and also pays for all or a portion of the cost of glasses or contact lenses if you need them. Your vision plan is through UnitedHealthcare and offers “in and out-of-network” benefits.

Insurance Carrier:

UnitedHealthcare Vision Insurance

Plan Type:

In-Network $10 Copay $25 Copay $25 Copay $25 Copay $25 Copay

Out-of-Network

Exam Copay

Up to $40 Up to $40 Up to $60 Up to $80 Up to $80

Lenses - Single lined Lenses - Bifocal lined Lenses - Trifocal Lenses - Lenticular

$ 130 Retail Allowance; then 30% off remaining balance

Frames

Up to $45

Elective Contact Lenses (in place of lenses & frame) Medically Necessary Contacts

$125 Retail Allowance

Up to $100

$0

Up to $210

Frequency for Exam / Lenses / Frames

12 months / 12 months / 24 months

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PAGE SCRANTOM 2024 BENEFITS GUIDE

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