2018 FEP BLUEVISION - Davis Vision · 2018 FEP BLUEVISION ... Standard Progressive Lenses $207 $50...
Transcript of 2018 FEP BLUEVISION - Davis Vision · 2018 FEP BLUEVISION ... Standard Progressive Lenses $207 $50...
Great care keeps you in focus.2018 FEP BLUEVISION®
Open Season is November 13 through midnight December 11, 2017 Eastern timeTo enroll visit BENEFEDS.com or call 1-877-888-FEDS (3337), TTY: 1-877-889-5680.
Questions? Contact FEP BlueVision Customer Service:Phone: 1-888-550-BLUE (2583), TTY: 1-800-523-2847; 8 a.m. to 8 p.m. Monday – Friday (Eastern time)
Learn more at www.fepbluevision.com
• Virtual Frame Try On
• Locate an FEP BlueVision Provider
• Learn about the Eye Exam
• Find out more about FEP BlueVision coverage
ZERO COPAYComprehensive
Routine Eye Exam
FULLY-COVEREDFEP BlueVision
Collection Frames 1
GENEROUSFrame Allowance at
Independent Providers & Retail Locations
ENHANCEDFrame Allowance for
High Option Members at of up to $200
EF PT O Z
Sample Eyewear PurchaseAverage
Retail CostStandard
OptionHigh
Option
Eye Examination $103 $0 $0
FEP BlueVision® Collection Frames $160 $0 $0
Standard Progressive Lenses $207 $50 $0
Ultraviolet Coating $23 $0 $0
Plastic Photosensitive Lenses (i.e. Transitions®) $110 $65 $0
Polycarbonate Lenses $66 $0 $0
1-Year Breakage Warranty $30 $0 $0
Total $699 $115 $0
SAVINGS $584 $699
OR
OVER 2,000 FRAMES TO CHOOSE FROM
ANNUITANT
No hidden costs. No out-of-pocket guesswork. FEP BlueVision members enjoy comprehensive coverage at significantly lower prices.
Enroll today and get started with a routine eye exam. Being proactive can help detect symptoms of systemic diseases such as diabetes, thyroid disease and neurological impairments.
BLUVISANN2018
2018 Premiums Standard Option High Option
BIWEEKLY MONTHLY BIWEEKLY MONTHLY
Self Only $3.95 $8.56 $5.67 $12.29
Self Plus One $7.90 $17.12 $11.33 $24.55
Self and Family $11.85 $25.68 $17.00 $36.83
Benefits Standard Option High Option
Optional Lenses and Treatments In-Network Only In-Network Only
Ultraviolet Protective Coating Nothing Nothing
Polycarbonate Lenses Nothing Nothing
Blended Segment Lenses $20 $20
Intermediate Lenses $30 $30
Standard Progressives $50 Nothing
Premium Progressives (Varilux®) $90 $90
Select Progressive Lenses $70 $70
Ultra Progressive Lenses (Digital) $195 $195
Photochromic Glass Lenses $20 $20
Plastic Photosensitive Lenses (Transitions® SignatureTM) $65 Nothing
Polarized Lenses $75 $75
Standard Anti-Reflective (AR) Coating $35 $20
Premium AR Coating $48 $33
Ultra AR Coating $60 $45
High-Index Lenses (up to 1.67)3 $55 $55
Benefits Standard Option High Option
Eye Exam (Once per year) No copay, covered every calendar yearSpectacle Lenses (One per year)
No copay, covered every calendar year
Lens Treatments Lens options are either covered-in-full or at significant savings over retail. For a complete list of lens treatment options, please refer to the 2018 brochure.
FEP BlueVision Exclusive Collection1 Covered-in-full and includes any frame from the FEP BlueVision Exclusive Collection1
Frames
No copay, covered every 2 calendar years
Non-Collection Frames: $130 toward any provider supplied frame, plus 20% off charges over $1302.
No copay, covered every calendar year
Non-Collection Frames: $150 toward any provider supplied frame, plus 20% off charges over $1502.
Additional $50 frame allowance when you purchase frames from any location.
Contact Lenses (in lieu of eyeglasses)
Up to $130 per calendar year toward contact lenses, evaluation, fitting and follow-up fees, plus 15% off charges over $1302.
Up to $150 per calendar year toward contact lenses plus 15% off charges over $1502. Evaluation, fitting and follow-up fees fully covered for non-specialty lenses and covered up to $60 for specialty contact lenses.
Vision Correction Surgery Save up to 40% to 50% on traditional LASIK surgery at QualSight LASIK. To take advantage of the discount, you must call 855-502-2020.
What you pay for in-network services
1Collection is available at participating independent provider offices. Collection is subject to change.2Additional discounts are not applicable at Costco, LensCrafters, Sam’s Club or Walmart locations.3Industry standard for Hi-Index
Note: This is a summary of the many features and benefits of FEP BlueVision. For a complete description, please refer to your benefit brochure.
The FEP BlueVision Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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