Quick Reference

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:
  • Up to $39 (frames)
  • Up to $28 (single vision lenses)
  • Up to $38 (bifocal lenses)
  • Up to $46 (trifocal lenses)
  • Up to $75 (lenticular lenses)
  • Up to $39 (progressive addition lenses)
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


Vision Benefits Summary