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Benefits

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 utilize a non‐network provider, you will be
responsible to pay 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 Plan

Network Name Blue View Vision Non-Network
Vision Benefits

Examination $25 copay, then covered in full $49 allowance
- Frequency 12 months 12 months
Lenses
- Single Vision $0 copay, then covered in full $35 allowance
- Bifocal $0 copay, then covered in full $49 allowance
- Trifocal $0 copay, then covered in full $74 allowance
- Progressive (Standard) $65 copay Discounts on lens upgrades are not
available out-of-network
- Frequency 12 months 12 months

Frames $130 allowance, $50 allowance
then 20% off any remaining balance
- Frequency 12 months 12 months
Contact Lenses
- Elective Conventional Lenses $130 allowance, $92 allowance
then 15% off any remaining balance
- Elective Disposable Lenses $130 allowance, no additional discount $92 allowance
- Frequency 12 months 12 months

Laser Vision Correction Discounts Apply Not Covered

Finding a Vision Provider
Go to www.anthem.com/ca or call (866) 723-0515. Refer to the “Blue View Vision” network when prompted.

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