Page 7 - Kagan Benefit Guide Out of CA.pub

Note
Kagan provides you with a selec on of
benefit op ons so you may choose the
coverage that is best for you and your family.

Benefits

Vision Insurance

The Anthem Blue Cross vision plan provides professional vision care and high quality lenses and frames through a broad network of op cal
specialists. You will receive richer benefits if you u lize a network provider. If you u lize a non‐network provider, you will be responsible to pay
all charges at the me of your appointment and will be required to file an itemized claim with Anthem.

Anthem Blue Cross
Blue View Vision

Network Name In‐Network Non‐Network
Vision Benefits
Copay
‐ Examina on $10 Copay $49 allowance
‐ Materials $20 Copay allowance varies

Lenses
‐ Single Vision No charge $35 allowance
‐ Bifocal No charge $49 allowance
‐ Trifocal No charge $74 allowance

Frames $130 allowance, then 20% off any re‐ $50 reimbursement
maining balance
Contact Lenses In Lieu of Frames and Lenses

‐ Cosme c / Elec ve $130 allowance $92 allowance
‐ Medically Necessary Covered in full $250 allowance
Laser Vision Correc on Discounts Apply Not Covered

Frequency
‐ Examina on 12 Months
‐ Lenses 12 Months
‐ Frames 12 Months
‐ Contact Lenses 12 Months

Finding a Vision Provider

Go to www.anthem.com/ca or call
(866) 723‐0515. Refer to the Blue View Vision network when prompted.

7