Page 11 - 2018 CareHere Enrollment
P. 11
CareHere
Vision
Vision Benefits
We partner with BlueCross BlueShield of Tennessee to offer you and your
family members vision insurance. Visit www.bcbst.com to ind in-network
providers and access to a variety of online tools and programs.
Vision Beneits At-a-Glance
In-Network*
Exams Covered in full, after $10 copayment
(every 12 months)
Lenses (every 12 months)
Single Covered 100% after $25 copay
Bifocal Covered 100% after $25 copay
Trifocal Covered 100% after $25 copay
Approved Frames (every 24 months)
$120 allowance
20% off balance over allowance
Approved Contact Lenses (every 12 months) in lieu of glasses
Elective—Conventional Lenses $120 allowance Vision coverage
15% off balance over allowance
Elective—Disposable Lenses $120 allowance is provided by
Medically Necessary 100% covered BlueCross BlueShield
of Tennessee.
* For out-of-network coverage details, please refer to your plan summary or an oficial plan
document.
Vision
Bi-Weekly
Employee Only $2.76
Employee + Spouse $5.52
Employee + Child(ren) $5.80
Family $9.11
11
Vision
Vision Benefits
We partner with BlueCross BlueShield of Tennessee to offer you and your
family members vision insurance. Visit www.bcbst.com to ind in-network
providers and access to a variety of online tools and programs.
Vision Beneits At-a-Glance
In-Network*
Exams Covered in full, after $10 copayment
(every 12 months)
Lenses (every 12 months)
Single Covered 100% after $25 copay
Bifocal Covered 100% after $25 copay
Trifocal Covered 100% after $25 copay
Approved Frames (every 24 months)
$120 allowance
20% off balance over allowance
Approved Contact Lenses (every 12 months) in lieu of glasses
Elective—Conventional Lenses $120 allowance Vision coverage
15% off balance over allowance
Elective—Disposable Lenses $120 allowance is provided by
Medically Necessary 100% covered BlueCross BlueShield
of Tennessee.
* For out-of-network coverage details, please refer to your plan summary or an oficial plan
document.
Vision
Bi-Weekly
Employee Only $2.76
Employee + Spouse $5.52
Employee + Child(ren) $5.80
Family $9.11
11
