Vision

Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.

Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.

Cigna Vision

Plan Information

Plan Name: Cigna Vision

Policy Number: 615165

Effective Date: 01/01/2025

Provider Network: Cigna

In-Network Benefit Highlights

Deductible (Individual/Family)
$XX/$XX

Out-of-Pocket Max (Individual/Family)
$XX/$XX

Preventive Care
$XX

Primary Care Visit
$XX

Specialist Visit
$XX

Urgent Care
$XX

Emergency Room
$XX

Benefit Highlights

In-Network

Exams
$0.00

Materials
$20 copay

Single Vision Lenses
$0.00 after materials copay

Bifocal Lenses
$0.00 after material copay

Trifocal Lenses
$0.00 after material copay

Frames
Up to $200 allowance

Contacts (in lieu of glasses)
Up to $200 allowance

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams
Up to $45 reimbursement

Materials
Reimbursed up to plan allowance after $20 copay

Single Vision Lenses
Up to $32 reimbursement after materials copay

Bifocal Lenses
Up to $55 reimbursement after materials copay

Trifocal Lenses
Up to $65 reimbursement after materials copay

Frames
Up to $110 reimbursement after materials copay

Contacts (in lieu of glasses)
Up to $160 reimbursement

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Contact Information