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YOUR HEAL TH                                                                      Login to your Anthem
                                                                                              account at anthem.com
            Anthem Blue View Vision
                                                                                              Download Mobile Health in the
                                                                                              App Store or Google Play














            866.723.05157  |  anthem.com


            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 full  $42 allowance
              Once every 12 months
              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







                                                                  COVERAGE                  MONTHLY RATE

                                                                  Single                    $7.36

                               Vision Plans                       Employee + Spouse         $12.86
                                2022 Rates                        Employee + Child(ren)     $13.96

                                                                  Family                    $21.30









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