Page 50 - Complete Hi-Res 7-product Kit
P. 50
Contact Lenses
• The Lincoln VisionConnect® plan gives you the option to choose contact lenses instead of eyeglass lenses.
Covered Contact Lens Selection
• The Lincoln VisionConnect® plan features a Covered Contact Lens Selection benefit. All of the following
contact lenses are covered in full after a low copay, if applicable:
Daily wear (30 lenses per box) Biweekly wear (6 lenses per box) Monthly wear (6 lenses per box)
Alcon® DAILIES® AquaComfort Plus® Alcon Freshlook® Handling Tint Alcon AIR OPTIX® AQUA
Alcon DAILIES AquaComfort Plus Toric CooperVision Avaira® CooperVision Biofinity®
CooperVision® Proclear® 1 day CooperVision Biomedics® 55 premier CooperVision Frequency® 55 aspheric
1-Day ACUVUE® Moist Bausch + Lomb SofLens® 38 CooperVision Proclear® sphere
ACUVUE 2 Bausch + Lomb PureVision® 2
Bausch + Lomb Ultra®
ACUVUE Vita®
• This benefit covers fitting and evaluation fees, up to four boxes of contact lenses (depending on the
prescription), and two follow-up visits.*
• The Covered Contact Lens Selection is not available at Walmart®, Sam’s Club®, or Costco®.
* The Covered Contact Lens Selection is subject to change. Your eye doctor’s prescribed wearing schedule may affect replacement frequency.
All trademarks are the property of their respective owners.
Other Contact Lens Options
• A $125 allowance is provided for all other contact lenses, as well as for contact lenses purchased at
Walmart, Sam’s Club, or Costco, with no copay.
— This allowance does not include the cost of a fitting/evaluation or follow-up.
Medically Necessary Contact Lenses
• Contact lenses are considered “medically necessary” at the discretion of the eye care provider, and are
covered 100% (after a low copay, if applicable) when you choose a network provider.
[Form Filing Number] Vision Insurance Plan Summary of Benefits
