avt.NavXp

Coverage

Enter Title

Click here for the details of the Vision Hardware plan.

Coverage In-Network Provider Out-of-Network Benefit
Materials Copay $20 N/A
Frame Retail Allowance (one per frequency period) Up to $130 Up to $52
Lenses:
Single vision
Bifocal
Trifocal
Lenticular
Covered 100% after Copay Covered 100% after CoPay Covered 100% after CoPay Covered 100% after CoPay Up to $45
Up to $55
Up to $65
Up to $80
Contact lenses - conventional: Once every year in lieu of lenses and/or frames
Therapeutic (must meet medically necessary criteria)
$130
Covered 100%
Up to $95
Up to $210