Schedule of Eligible Services. Effective December 1, 2009, reimbursement for prescription eye glasses (frames and/or lenses) or contact lenses every 24 months up to a maximum of: Single Vision Lenses $220.00 Bi-focal Lenses $275.00 Multi-focal Lenses $345.00 Contact Lenses $230.00 Effective December 1, 2009, reimbursement to a maximum of $85.00 for a routine eye examination, once in a twenty-four (24) month period, provided by either an optometrist or physician (as defined in III) for patients aged 20 through 64 when the benefit is not covered by the person's provincial health care plan. Repairs (not replacements) at the usual and customary rates as determined by the carrier will be allowed in addition to the above scheduled amounts. Reimbursement for laser eye surgery up to a maximum lifetime benefit of $345.00. A covered person reimbursed for such laser eye surgery will not be eligible for any other reimbursement under this Exhibit IV for a period of forty-eight (48) months. Commencement of the benefit period is based on the initial date vision benefits are received.
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