Page 59 - APPENDICES for Vic Bosiger
P. 59
VISION
Routine eye exam $0 copay Limits apply
Contact lenses $0 copay Limits apply
Eyeglasses (frames & $0 copay Limits apply
lenses)
Eyeglass frames only Not covered
Eyeglass lenses only Not covered
Upgrades Not covered
MEDICALLY-APPROVED NON-OPIOID PAIN MANAGEMENT SERVICES
Chiropractic services Not covered
Acupuncture Not covered
Massage therapy Not covered
Alternative therapies Not covered
