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  Sample Plan Description
Avesis Advantage Fully Insured Plan
 

This is just 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 needs.

 
 
     
In-Network
Out-of-Network
   
  Vision Examination   $10.00 Copay   N/A
  Materials   $10.00 Copay   N/A
           
  Vision Examination   Covered in full after the co-pay   Reimbursed up to $35
           
  Spectacle Lenses        
  Standard Single Vision   Covered in full after the co-pay   Reimbursed up to $25
  Standard Bifocal   Covered in full after the co-pay   Reimbursed up to $40
  Standard Trifocal   Covered in full after the co-pay   Reimbursed up to $50
  Standard Lenticular   Covered in full after the co-pay   Reimbursed up to $80
  Progressive   20% off retail, minus a
$50 allowance		   Reimbursed up to $40
  Specialty Lenses   20% off retail, minus the corresponding standard
lens plan payment		   Corresponding standard lens reimbursement
           
  Lens Options
(tints, coatings, etc.)		   Up to 20% off retail   N/A
           
  Frame   $50 wholesale allowance after the co-pay (approximate
retail up to $100 - $150)		   Reimbursed up to $45
           
 

Contact Lenses

Elective

   $130 Allowance (in lieu of frame and spectacle lenses) after the Avesis Preferred Pricing Discount has been applied   Reimbursed up to $130 (Depending on plan selected)
  Medically Necessary   Covered in full (in lieu of frame
and spectacle lenses)		   up to $250
           
  Laser Vision Correction   Avesis has contracted with participating providers to provide significant discounts for Lasik surgery. You may call (888)
314-4619 for additional information or for a participating
provider in your area.
           
  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
           
  Frequency        
 
Exam		   Once every 12 or 24 Months   Once every 12 or 24 Months
  Frame   Once every 12 or 24 Months   Once every 12 or 24 Months
  Spectacle Lenses or Contacts   Once every 12 or 24 Months   Once every 12 or 24 Months
 

 
   
   
 
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