Page 11 - Genesis Care 2022 Benefit Guide

Medical & Spending Voluntary Additional
Contents Prescription Dental Vision Accounts Life & AD&D Disability Benefits 401(k) Information Contacts

VISION

Our vision plan, offered through Ameritas, provides coverage for routine eye exams and pays
for all or a portion of the cost of glasses or contact lenses. You can choose any provider;
however, you always save money if you see in-network providers.

VSP VISION NETWORK FREQUENCY IN-NETWORK OUT-OF-NETWORK
DEDUCTIBLES

Exam $15 Up to $45
Once every
Materials 12 months $15 1 See below

LENSES
Single Vision Up to $30

Bifocals Up to $50
Once every 100% after deductible
Trifocals 12 months Up to $65

Lenticular Up to $100

FRAMES
Up to $130
Once every
Retail Allowance (or Costco/Walmart Up to $70
12 months
wholesale equivalent)
CONTACTS

Medically Necessary Covered in full Up to $210
Once every
Elective (in lieu of 12 months
eyeglasses) Up to $130 Up to $105

1 The copay applies to a complete pair of glasses or to frames, whichever is selected.

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