Page 11 - 2023 Microbe Benefit Guide

Vision Plan

The vision plan 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. We offer a vision plan through BlueCross of Idaho.

BlueCross of Idaho Vision Plan
Plan Provisions In-Network Out-of-Network

Exam $10 copay Up to $45

$130 allowance,
Frames then 20% off Up to $47
remaining balance

Lenses
▪ Single Vision Up to $45
$25 copay
▪ Bifocal Up to $65
▪ Trifocal Up to $85
Progressive Lenses
▪ Standard $55 copay
Up to $65
▪ Premium $95-$105 copay
▪ Custom $150-$175 copay

Contact Lenses (in lieu of glasses)
▪ Elective $130 allowance Up to $105
▪ Medically Necessary Covered in full Up to $210

Frequency
▪ Exam Once every 12 months Once every 12 months
▪ Lenses Once every 12 months Once every 12 months
▪ Frames Once every 12 months Once every 12 months
▪ Contact Lenses Once every 12 months Once every 12 months
Extras Savings and Discounts
▪ Glasses & Sunglasses 20% off additional glasses and sunglasses, including
lens options
▪ Laser Vision Correction 15% off regular price or 5% off promotional price N/A

Pay for vision expenses tax-free
Use your FSA or HSA to pay for your exam copay and eyeglasses or contacts.

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