Vision
Quick Reference
Website
Call Davis Vision customer service: 800-999-5431
Coverage Highlights
- You can receive care from any vision provider
- Care and supplies received from in-network vision providers cost you less because in-network vision providers discount their fees and can’t balance bill you
| In-Network | Out-of-Network | |
|---|---|---|
| Exam (once every 12 months) | $0 copayment | Benefit of up to $42 |
| Eyeglass Frames and Lenses | $0 copay (for fashion/designer level frames from Davis Vision’s frame collection; for other frames, $111 credit applies) | Benefit of:
|
| Non-Preferred Brand Name | $50 copayment | $100 copayment |
| Contact Lenses (instead of glasses) | $0 copayment (for Davis Vision’s contact lens collection; for other contact lens collections, $105 credit applies) | Benefit of up to $150 for elective contact lenses; benefit of up to $300 when lenses are medically necessary |
| Safety Eyeglasses (once every 12 months, in addition to regular eyeglasses frames and lenses) | $0 copayment (employees only) | No benefit |