Page 9 - 2019 NextCare
P. 9
Vision
NextCare offers vision insurance through Delta Dental of Arizona using the EyeMed network. You will receive
an ID card in the mail after enrollment.
In-Network Out-of-Network
Exam (every 12 months) $10 copay Up to $30 reimbursement
Single Lenses (every 12 months) $10 copay Up to $25 reimbursement
Bifocal Lenses (every 12 months) $10 copay Up to $40 reimbursement
Trifocal Lenses (every 12 months) $10 copay Up to $55 reimbursement
Lenticular Lenses (every 12 months) $10 copay Up to $55 reimbursement
Frames (every 12 months) $150 allowance, plus 20% off amount Up to $75 reimbursement
over allowance
Elective Contacts (every 12 months in Conventional: $150 allowance, plus Up to $120 reimbursement
lieu of glasses) 15% off balance over $150
Disposable: $0 copay; $150
allowance, plus balance over $150
Employee Vision Cost Per Pay Period
Employee Only $3 .76
Employee and Spouse $6 .01
Employee and Child(ren) $6 .14
Family $9 .90
NextCare Holdings 9
NextCare offers vision insurance through Delta Dental of Arizona using the EyeMed network. You will receive
an ID card in the mail after enrollment.
In-Network Out-of-Network
Exam (every 12 months) $10 copay Up to $30 reimbursement
Single Lenses (every 12 months) $10 copay Up to $25 reimbursement
Bifocal Lenses (every 12 months) $10 copay Up to $40 reimbursement
Trifocal Lenses (every 12 months) $10 copay Up to $55 reimbursement
Lenticular Lenses (every 12 months) $10 copay Up to $55 reimbursement
Frames (every 12 months) $150 allowance, plus 20% off amount Up to $75 reimbursement
over allowance
Elective Contacts (every 12 months in Conventional: $150 allowance, plus Up to $120 reimbursement
lieu of glasses) 15% off balance over $150
Disposable: $0 copay; $150
allowance, plus balance over $150
Employee Vision Cost Per Pay Period
Employee Only $3 .76
Employee and Spouse $6 .01
Employee and Child(ren) $6 .14
Family $9 .90
NextCare Holdings 9
