Common use of Contact Lenses Clause in Contracts

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4J-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 J-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4E-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 E-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.evaluation

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4J-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 J-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.the

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4E-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 E-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance. The copayment provision under (3) is not required.

Contact Lenses. Medically Necessary: The Plan will cover medically necessary contact lenses once every twelve (12) months with an employee co-payment identified in Appendix K-4G-4. Medically necessary means (a) must correct the member’s acuity to 20/70 or better in the better eye or (b) the member has one of the following visual conditions: kerataconus, irregular astigmatism, or irregular corneal curvature. Not Medically Necessary: The Plan will pay a maximum allowance identified in Appendix K-4 G-4 and the employee shall pay any additional charge of the provider for such contact lenses. The contact lens evaluation is included in the cost of the contact lens allowance.