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VISION INSURANCE

ANTHEM BLUE CROSS | PPO VISION PLAN

The Anthem Blue Cross vision plan provides professional vision care and high-quality lenses and frames through a broad network of optical
specialists. You will receive richer benefits if you utilize a network provider. If you use a non‐network provider, you will be responsible for
paying all charges at the time of your appointment and will be required to file an itemized claim with Anthem Blue Cross.

Anthem’s network includes access to more than 44,000 providers and provider locations including independent ophthalmologists and
optometrists, as well as LensCrafters®, Target Optical, Sears Optical, JCPenney Optical and most Pearle Vision retail stores.

ANTHEM BLUE CROSS
PLAN NAME PPO

Network Name Blue View Vision Non‐Network
Vision Benefits
Copay
- Examination $10 Copay N/A
- Materials $25 Copay N/A
Examination (Every 12 Months) No Charge After Copay $49 Reimbursement

Lenses (Every 12 Months)
- Single Vision No Charge After Copay $35 Reimbursement
- Bifocal No Charge After Copay $49 Reimbursement
- Trifocal No Charge After Copay $74 Reimbursement
Frames (Every 12 Months) $130 Allowance $50 Reimbursement
then 20% Discount
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
- Cosmetic / Elective $130 Allowance $92 Reimbursement
- Medically Necessary No Charge $250 Reimbursement

Discounts:
Savings on items like additional eyewear after your benefits have been used, non-prescription sunglasses, hearing aids and even LASIK laser
vision correction surgery are available through a variety of vendors.

Just log in at www.anthem.com/ca, select discounts, then Vision, Hearing & Dental.

FINDING A VISION PROVIDER
Go to www.anthem.com/ca or call (866) 723-0515. Refer to the Blue View Vision network.

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