Page 9 - Fort Health Care 2022 Benefit Guide

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VISION

Employees have two options for vision coverage:

1) Eye Exam Only offered through the Medical Plan
a) Services provided at Davis Duehr Dean

2) Vision Coverage through VSP
The vision plan through VSP covers routine eye exams and also pays for all or a
portion of the cost of glasses or contact lenses if you need them. Network: VSP

a) Materials Only Plan
i) Can supplement the eye exam in the medical plan. Covers the cost of
materials only.
b) Full-Service Plan
i) Covers both your exam and your materials

Benefit Materials Only Plan Full-Service Plan
In-Network Out-of-network In-Network Out-of-Network
Exam N/A N/A $10 Copay $35 Allowance
Materials $25 Copay N/A $25 Copay N/A
Frequency
◼ Exam N/A 12 Months
◼ Lenses or Contacts 12 Months 12 Months
◼ Frames 24 Months 24 Months
Frames $150 Allowance $75 Allowance $150 Allowance $75 Allowance
Lenses
◼ Single Vision Lenses $25 Allowance $25 Allowance
◼ Bifocal Lenses $25 Copay $40 Allowance $25 Copay $40 Allowance
◼ Trifocal Lenses $$45 Allowance $$45 Allowance
Contact Lenses Covered in lieu of glasses Covered in lieu of glasses
◼ Contact Lens Fit and Covered as part of Covered as part of Covered as part of Covered as part of
Follow-up contact lens benefit contact lens benefit contact lens benefit contact lens benefit
◼ Elective $150 Allowance $125 Allowance $150 Allowance $125 Allowance
◼ Medically Necessary Covered in Full $150 Allowance Covered in Full $150 Allowance
LASIK Coverage Average 15% discount Average 15% Discount Average 15% discount Average 15% discount
– In lieu of Eyewear – in lieu of Eyewear – In lieu of Eyewear – In lieu of Eyewear
benefit benefit benefit benefit
Add’ l Materials Discount 20% N/A 20% N/A

Guide to Your Benefits | May 1, 2022 – April 30, 2023