Schedule of Vision Insurance Benefits. (1) In-network provider benefits: Professional Services Examination co-pay $ 5.00 Materials Prescription glasses co-pay $ 12.50 • Includes single vision, bifocal, lenticular or trifocal lenses • Lens enhancements are an extra cost to member and not included in the co-pay. Retail frame allowance $135.00 Contact Lenses – necessary $195.00 Contact Lenses – cosmetic $115.00
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Samples: Preamble and Purpose, Preamble and Purpose, serb.ohio.gov
Schedule of Vision Insurance Benefits. (1) In-network provider benefits: Professional Services Examination co-pay $ $5.00 Materials Prescription glasses co-pay $ $12.50 • Includes single vision, bifocal, lenticular or trifocal lenses • Lens enhancements are an extra cost to member and not included in the co-pay. Retail frame allowance $135.00 Contact Lenses – necessary $195.00 Contact Lenses – cosmetic $115.00135.00
Appears in 1 contract
Samples: serb.ohio.gov
Schedule of Vision Insurance Benefits. (1) In-network provider benefits: Professional Services Examination co-pay $ $5.00 Materials Prescription glasses co-pay $ $12.50 • Includes single vision, bifocal, lenticular or trifocal lenses • Lens enhancements are an extra cost to member and not included in the co-pay. Retail frame allowance $135.00 Contact Lenses – necessary $195.00 Contact Lenses – cosmetic $115.00135.00.
Appears in 1 contract
Samples: Regarding Certification Incentive