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Sample Vision Plan Design The Avesis vision plans are fully customizable. Below is just a sampling of one of the dozens of plan designs we offer. Please contact a Regional Vice President of Sales to discuss how we can provide the benefit design to fit your client's needs. In-Network Out-of-Network Copay Examples Vision Examination Materials $10.00 Copay $10.00 Copay N/A N/A Covered in full after the co-pay N/A Standard Single Vision Standard Bifocal Standard Trifocal Standard Lenticular Progressive Specialty Lenses Covered in full after the co-pay Covered in full after the co-pay Covered in full after the co-pay Covered in full after the co-pay 20% off retail, minus a $50 allowance 20% off retail, minus the corresponding standard lens Reimbursed up to $25 Reimbursed up to $40 Reimbursed up to $50 Reimbursed up to $80 Reimbursed up to $40 Corresponding standard lens reimbursement Lens Options (tints, coatings, etc.) Up to 20% off retail N/A $50 wholesale allowance (approximate retail up to Reimbursed up to $45 Contact Lenses Elective Medically Necessary $130 Allowance (in lieu of frame and spectacle lenses) after the Avesis Preferred Pricing Discount has been applied Covered in full (in lieu of frame and spectacle lenses) Reimbursed up to $130 up to $250 Laser Vision Correction The Avesis plans include a funded option for LASIK services. Allowance amounts of $100 or $150 are available depending on which plan is selected. Avesis even has plan options for allowances of $300 or $600 to use towards LASIK services. When using an in-network provider a discount ranging from 5 -25% is applied prior to the allowance. Additional Purchases/Items not covered Items not covered under the program and/or additional purchases are available on an unlimited basis at up to 20% off of retail N/A Exam Frame Spectacle Lenses or Contacts Once every 12 or 24 Months Once every 12 or 24 Months Once every 12 or 24 Months |