Vision
The USPS Health Benefit Plan includes preventive vision care at no additional cost.
Take a closer look at your plan:
| In-Network | You Pay |
|---|---|
| Eye Examinations | |
| Routine Eye Examination with dilation (per benefit period) | $10 |
| Frames1 | |
| Priced up to $70 retail | $40 |
| Priced above $70 retail | $40, plus 90% of the amount over $70 |
| Spectacle Lenses1 | |
| Single Vision | $35 |
| Bifocal | $55 |
| Trifocal | $65 |
| Lenticular | $110 |
| Lens Options1, 2(add to spectacle lens prices above) | |
| Standard Progressive Lenses | $75 |
| Premium Progressive Lenses (Varilux®, etc.) | $125 |
| Ultra Progressive Lenses (digital) | $140 |
| Polarized Lenses | $75 |
| High Index Lenses | $55 |
| Glass Lenses | $18 |
| Polycarbonate Lenses | $30 |
| Blended invisible bifocals | $20 |
| Intermediate Vision Lenses | $30 |
| Photochromic Lenses | $35 |
| Scratch-Resistant Coating | $20 |
| Standard Anti-Reflective (AR) Coating | $45 |
| Ultraviolet (UV) Coating | $15 |
| Solid Tint | $10 |
| Gradient Tint | $12 |
| Plastic Photosensitive Lenses | $65 |
| Contact Lenses1 | |
| Contact Lens Evaluation and Fitting | 85% of retail price |
| Conventional | 80% of retail price |
| Disposable/Planned Replacement | 90% of retail price |
| DavisVisionContacts.com Mail Order Contact Lens Replacement Online | Discounted prices |
| Laser Vision Correction1 | |
| Up to 25% off allowed amount or 5% off any advertised special3 | |
| Out-of-Network | You Pay |
| Routine Eye Examination with dilation (per benefit period) | Plan pays $33, you pay balance |
1 CareFirst BlueChoice does not underwrite lenses, frames and contact lenses in this program. This portion of the Plan is not an insurance product. As of 4/1/14, some providers in Maryland and Virginia may no longer provide these discounts.
2 Special lens designs, materials, powers and frames may require additional cost.
3 Some providers have flat fees that are equivalent to these discounts.
Exclusions
The following services are excluded from coverage:
Diagnostic services, except as listed in What’s Covered under the Evidence of Coverage.
Medical care or surgery. Covered services related to medical conditions of the eye may be covered under the Evidence of Coverage.
Prescription drugs obtained and self-administered by the Member for outpatient use unless the prescription drug is specifically covered under the Evidence of Coverage or a rider or endorsement purchased by your Group and attached to the Evidence of Coverage.
Services or supplies not specifically approved by the Vision Care Designee where required in What’s Covered under the Evidence of Coverage.
Orthoptics, vision training and low vision aids.
Glasses, sunglasses or contact lenses.
Vision Care services for cosmetic use.
Exclusions apply to the Routine Eye Examination portion of your vision coverage. Discounts on materials such as glasses and contacts may still apply.
Benefits issued under policy form numbers: MD/CF/VISION (R. 10/11) • DC/CF/VISION (R. 1/06) • VA/CF/VISION (R. 1/06) • CFMI/Vision Rider (10/11) • MD/BCOO/VISION (R. 10/11) • DC/BCOO/VISION (R. 1/06) • VA/BCOO/VISION (R. 1/06) and any amendments.