Limitations Frequency. (A) If a covered person has received lenses and frames or contact lenses for which benefits were payable under the Schedule of Eligible Services, or the prior program, subsequent benefits will be payable only if received more than twenty-four (24) months after the date of the most recent approved claim. If the reimbursement maximums have not been reached, subsequent claims will be allowed within the twenty-four (24) month period, up to the applicable reimbursement maximums. Lenses and frames received under the company's prescription safety glasses program shall not be considered lenses and frames received under this program.
(B) A covered person with diabetes or other medical conditions requiring frequent lens changes (as substantiated by an ophthalmologist) will be eligible for new lenses whenever they have a prescription change.
(C) Contact lenses will be covered every twelve (12) months, when the covered person's visual acuity cannot otherwise be corrected to at least 20/70 in the better eye, or when medically necessary due to keratoconus, irregular astigmatism, irregular corneal curvature or physical deformity resulting in an ability to wear normal frames.
(D) Repairs to frames will not be subject to a frequency limitation.
Limitations Frequency. If a covered person has received a hearing aid for which benefits were payable under the Plan, benefits will be payable for each subsequent hearing aid only if received more than 36 months after receipt of the most recent previous hearing aid, for which benefits were payable under the Plan.
Limitations Frequency. (1) If a covered person has received lenses or frames or contact lenses for which benefits were payable under the Schedule of Eligible Services, subsequent benefits will be payable only if received more than 24 months after the date that benefits were initially paid in the prior period.
(2) If a covered person has diabetes or other medical conditions requiring frequent lens changes (as substantiated by an ophthalmologist or optometrist), they will be eligible for new lenses whenever they have a prescription change.
(3) Contact lenses will be covered every 12 months, when the covered person’s visual acuity cannot otherwise be corrected to at least 20/70 in the better eye, or when medically necessary due to keratoconus, irregular astigmatism, irregular corneal curvature or physical deformity resulting in an inability to wear normal frames.
(4) Repairs to frames will not be subject to a frequency limitation.
