CareFirst BlueCross BlueShield
Contact Us Glossary Search the CareFirst State of Maryland Web Site
State of Maryland
My Account Find a Doctor Plan Descriptions Forms
State of Maryland Plan Descriptions Routine Vision Benefits Schedule

Routine Vision Benefits Schedule

Plan Highlights:

This vision plan is for members enrolled in our BlueChoice HMO Plan.

  • You may use any vision care provider and any vision dealer for lens and frame purchases.
  • Those providers and dealers who participate with CareFirst BlueCross BlueShield will submit your vision claims for you.
  • Participating vision providers will be reimbursed with vision schedule allowances for services provided.
  • All vision providers may balance bill the member for charges above the scheduled allowances.

For services provided by a non-participating provider, you will have to file the claim and be reimbursed for services. You can download a vision claim form or call the State operations center at 410-581-3601 for claim forms.

Routine Eye Exam
The plan pays up to $45 for a routine eye exam. This service is available once per year. Benefits are not included for eye refractions.

Prescription Lenses (per pair)
(
Available once every year)
 
Single Vision $
28.80
Bifocal, single $
48.60
Bifocal, double $
88.20
Trifocal $
70.20
Aphakic, Glass $
54.00
Aphakic, Plastic $
126.00
Aphakic, Aspheric $
162.00

Frames (Available once every year) $
45.00

Contacts (per pair, in lieu of frames & lenses)
(Available once every year)
Medically neccessary $
201.60
Cosmetic $
50.40
Solution Center
Member ID Cards
Select or Change your PCP
Order ID Cards
Nurse Line (FirstHelp)
Frequently Asked Questions
Contact Us
TTY Users
What's New for 2009/2010 Plan Year?
Health & Wellness
My Care First
Options Discount Program
Blue365 - More Wellness Savings
Health & Wellness Services
News & Updates

CareFirst H1N1 Vaccine Policy PDF

What Does Your New Member ID Card Look Like?

Member ID Card Information PDF

What is an EPO Plan?

Customer Service Hours

Get monthly health news by e-mail

Vitality Member Newsletter

News Archives

 
Adobe Acrobat PDF Viewing and printing this document requires Adobe Acrobat Reader, which can be downloaded free from the Adobe site.

Serving Maryland, the District of Columbia and portions of Virginia. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®' Registered trademark of CareFirst of Maryland, Inc. 
 
This site is best viewed in IE 7.0 or higher or FireFox 3.0 or higher.