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Vision Coverage Level

Which Coverage Level Is Best?

You get to choose how much coverage you need and how you want to pay for it. When you choose your coverage level, you get to pick the one with the features you want.

Your coverage level determines how much you pay out of your paycheck (premiums). It also determines how much you pay out of your pocket when you receive care. Make sure to take your total costs into consideration when choosing a coverage level.

Don’t let the names of the coverage levels fool you. One option isn’t better than another. The coverage levels are designed to give you choices. It’s up to you to find the one that makes sense for your situation.

Vision Coverage Level Options

Bronze Silver Gold
In-Network Benefits
Routine vision exam (once per plan year)

Covered 100%

You pay $20

You pay $10

Frames (once per plan year)

Discount may apply

$130 allowance1

$200 allowance1

Lenses (once per plan year; premium lenses may cost more)
Single vision

Discount may apply

You pay $20

You pay $10

Bifocal

Discount may apply

You pay $20

You pay $10

Trifocal

Discount may apply

You pay $20

You pay $10

Standard Progressive2

Discount may apply

You pay $20

You pay $10

Lenticular

Discount may apply

You pay $20

You pay $10

Lens Enhancements
UV treatment

Discount may apply

Varies by carrier

Varies by carrier

Tint (solid and gradient)

Discount may apply

Varies by carrier

Varies by carrier

Standard plastic scratch-resistant coating

Discount may apply

Varies by carrier

Varies by carrier

Standard anti-reflective coating

Discount may apply

Varies by carrier

Varies by carrier

Standard polycarbonate (adults)

Discount may apply

Varies by carrier

Varies by carrier

Standard polycarbonate (children)

Discount may apply

You pay nothing

You pay nothing

Other add-ons

Discount may apply

Discount only

Discount only

Contact Lenses
Medically necessary

Not covered

You pay $20

You pay $10

Elective

Not covered

$130 allowance1

$200 allowance1

Fit and evaluation

Discount may apply

You pay $20

You pay $10

Laser Surgery
Elective

15% off regular price or 5% off promotional price

15% off regular price or 5% off promotional price

15% off regular price or 5% off promotional price


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