Blue Cross Blue Shield FEP Vision
Section 5 Vision Services and Supplies
Section 5 Vision Services and Supplies
Contact Lenses
Benefit Description
Contact Lenses: covered once every calendar year – in lieu of eyeglasses.
*Note: Additional discounts are available from in-network independent providers. In-network national and online retailers do not offer the discount.
**Note: Pre-authorization is required.
High Option – You Pay
In-Network: Expenses in excess of a $150 allowance. Additionally, a 15% discount applies to any amount over $150.*
The evaluation, fitting and follow-up care is covered in full for Non-Specialty contact lenses. For Specialty lenses (including, but not limited to, toric, multifocal and gas permeable lenses), you receive $60 toward the contact lens evaluation and fitting, plus a 15% discount off the balance over $60*. Participating providers will bill you for anything over the $60 less the discount so you do not have to file a claim.
Expenses in excess of $600 for medically necessary contact lenses.**
Out-of-Network: Expenses in excess of fee schedule allowance of:
$75 elective contact lenses
$225 medically necessary contact lenses
Standard Option – You Pay
In-Network: Expenses in excess of a $140 allowance. Additionally, a 15% discount applies to any amount over $140.*
The evaluation, fitting and follow-up care is covered with a $55 copay for non-specialty contacts, plus a 15% discount off the balance.
Participating providers will bill you for anything over the $55, less the discount, so you do not have to file a claim.
Expenses in excess of $600 for medically necessary contact lenses.**
Out-of-Network: All charges
Contact Lenses: covered once every calendar year – in lieu of eyeglasses.
*Note: Additional discounts are available from in-network independent providers. In-network national and online retailers do not offer the discount.
**Note: Pre-authorization is required.
High Option – You Pay
In-Network: Expenses in excess of a $150 allowance. Additionally, a 15% discount applies to any amount over $150.*
The evaluation, fitting and follow-up care is covered in full for Non-Specialty contact lenses. For Specialty lenses (including, but not limited to, toric, multifocal and gas permeable lenses), you receive $60 toward the contact lens evaluation and fitting, plus a 15% discount off the balance over $60*. Participating providers will bill you for anything over the $60 less the discount so you do not have to file a claim.
Expenses in excess of $600 for medically necessary contact lenses.**
Out-of-Network: Expenses in excess of fee schedule allowance of:
$75 elective contact lenses
$225 medically necessary contact lenses
Standard Option – You Pay
In-Network: Expenses in excess of a $140 allowance. Additionally, a 15% discount applies to any amount over $140.*
The evaluation, fitting and follow-up care is covered with a $55 copay for non-specialty contacts, plus a 15% discount off the balance.
Participating providers will bill you for anything over the $55, less the discount, so you do not have to file a claim.
Expenses in excess of $600 for medically necessary contact lenses.**
Out-of-Network: All charges