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Exclusions and Limitations

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)

The following are not covered:

  • Two pair of glasses instead of bifocals
  • Replacement of lenses, frames or contact lenses
  • Medical or surgical treatment
  • Orthoptics
  • Vision training or supplemental testing
  • Other insurance policies or service agreements
  • Artistically painted non-prescription lenses
  • Additional office visits for contact lens pathology
  • Contact lens modification, polishing or cleaning

A full description of the vision benefit is included in the member's Evidence of Coverage (EOC).

Last Updated: 07/01/2024