Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to: A. Case history; B. External examination of the eye and adnexa; C. Ophthalmoscopic examination; D. Determination of refractive status; E. Binocular balance testing; F. Tonometry test for glaucoma;
Appears in 10 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement, Individual Enrollment Agreement
Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to:
A. Case history;
B. External examination of the eye and adnexa;
C. Ophthalmoscopic examination;
D. Determination of refractive status;
E. Binocular balance testing;
F. Tonometry test for glaucoma;
Appears in 5 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan
Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to:
A. Case history;
B. External examination of the eye and adnexa;
C. Ophthalmoscopic examination;
D. Determination of refractive status;
E. Binocular balance testing;
F. Tonometry test for glaucoma;
X. Xxxxx visual field testing;
H. Color vision testing;
I. Summary finding; and SAMPLE J. Recommendation, including prescription of corrective lenses.
Appears in 4 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement
Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to:
A. Case history;
B. External examination of the eye and adnexa;
C. Ophthalmoscopic examination;
D. Determination of refractive status;
E. Binocular balance testing;
F. Tonometry test for glaucoma;; SAMPLE
Appears in 1 contract
Samples: Individual Enrollment Agreement for a Qualified Health Plan
Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to:
A. Case history;
B. External examination of the eye and adnexa;
C. Ophthalmoscopic examination;
D. Determination of refractive status;
E. Binocular balance testing;
F. Tonometry test for glaucoma;
X. Xxxxx visual field testing; SAMPLE
H. Color vision testing;
I. Summary finding; and J. Recommendation, including prescription of corrective lenses.
Appears in 1 contract
Samples: Student Health Plan Individual Enrollment Agreement
Covered Services. Coverage will be provided for Members age 19 and over for one (1) routine eye examination, including dilation, if professionally indicated, each Benefit Period. A vision examination may include, but is not limited to:
A. Case history;
B. External examination of the eye and adnexa;
C. Ophthalmoscopic examination;
D. Determination of refractive status;
E. Binocular balance testing;
F. Tonometry test for glaucoma;
X. Xxxxx visual field testing;
H. Color vision testing; Sample
I. Summary finding; and J. Recommendation, including prescription of corrective lenses.
Appears in 1 contract
Samples: Individual Enrollment Agreement for a Qualified Health Plan
