Page 19 - Gray_2020 Benefit Guide
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Quick Contact Details:
PHONE: 866-723-0515
Your Health WEBSITE: anthem.com
ANTHEM BLUE Login to your Anthem
account at anthem.com
VIEW VISION Download Mobile Health in the
App Store or Google Play
Your eyesight plays an important role in your
overall wellness. In addition to measuring your
vision, regular eye exams help identify early
signs of certain chronic health conditions.
Your Blue View Vision Plan At-A-Glance
VISION CARE SERVICES IN-NETWORK OUT-OF-NETWORK
Routine eye exam $10 copay, then covered in $42 allowance
Once every 12 months full
Eyeglass Frames $130 allowance $45 allowance
Once every 24 months
Eyeglass Lenses (Standard)
Once every 12 months
• Standard plastic single vision lenses (1 pair) $20 copay $40 allowance
• Standard plastic bifocal lenses (1 pair) $20 copay $60 allowance
Contact lenses
Once Every 12 months
• Elective conventional lenses $130 allowance $130 allowance
• Elective disposal lenses $130 allowance $130 allowance
• Non-elective conventional lenses Covered in full Covered in full
2020 Rates
VISION PLAN COVERAGE MONTHLY RATE
Single $7.36
Employee + Spouse $12.86
Employee + Child(ren) $13.96
Family $21.30
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