Page 9 - Advertise Purple Benefit Guide

Vision Insurance

Guardian | PPO
The Guardian 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 respon-
sible for paying all charges at the time of your appointment and will be required to file an itemized claim with Guardian.

Guardian Guardian:
Plan Name PPO Guardian’s Vision plan
utilizes the VSP
Network Name VSP Choice Network Non-Network
network, which has
Vision Benefits the most extensive
network of private-
Copay practice eye care
- Examination $10 Copay N/A
doctors in the
- Materials $25 Copay N/A
industry. Most of the
Examination (Every 12 Months) No Charge after Copay Up to $39 Reimbursement U.S. population lives
within four miles of a
Lenses (Every 12 Months) VSP provider. VSP also
- Single Vision No Charge after Copay Up to $23 Reimbursement contracts with Costco
- Bifocal No Charge after Copay Up to $37 Reimbursement
Optical, Visionworks,
- Trifocal No Charge after Copay Up to $49 Reimbursement
and other affiliate
Frames (Every 24 Months) $130 Allowance Up to $46 Reimbursement retail providers. Please
note, benefits may
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
vary at affiliate
- Cosmetic / Elective $130 Allowance Up to $100 Reimbursement locations.
- Medically Necessary No Charge Up to $210 Reimbursement

Finding a Vision Provider
Go to www.guardiananytime.com or call (888) 600-1600. Refer to the VSP Choice network when prompted.

9
8