IQVIA Benefits Handbook
BENEFITS COVERED BY THE VISION PLAN
The following chart shows how exams, lenses, frames and contact lenses are covered by the Vision Plans and how benefits are paid when using an in-network or Open Access provider. Keep in mind that both Vision Plans provide coverage once every 12 months for glasses or contacts—not both.
Benefit
|
Standard Plan
|
Enhanced Plan
|
|
In-Network Provider
|
Open Access Provider
|
In-Network Provider
|
Open Access Provider
|
Routine exam (one exam per person every 12 months)
|
100% after $10 copay
|
Up to $40
|
100% after $10 copay
|
Up to $50
|
Lenses (one pair of lenses per person every 12 months)
|
|
Up to:
|
|
Up to:
|
|
100% after $25 copay
|
|
100% after $10 copay
|
|
|
|
|
|
|
|
Lens Options
|
Standard progressive lenses covered 100% after $80 copay; copays range from $110 to $200 for Premium progressive lenses
|
Progressive lenses reimbursed up to
$50
|
Standard progressive lenses covered 100% after $10 copay; copays range from $95 to $185 for Premium progressive lenses
|
Progressive lenses reimbursed up to
$70
|
Frames
|
Every 24 months. Up to a retail allowance of $130, plus 20% off any amount over your allowance
|
Up to $91
|
Every 12 months. Up to a retail allowance of $175, plus 20% off any amount over your allowance
|
Up to $125
|
Contact lenses (one pair of lenses per person every 24 months, in lieu of spectacle lenses and frames)
|
|
|
Medically necessary (i.e., if eye glasses will not correct vision impairment)
|
100%; $0 copay
|
Up to $300
|
100%; $0 copay
|
Up to $300
|
Elective Contacts
|
Up to $130 retail allowance
|
Up to $91
|
Up to $175 retail allowance
|
Up to $125
|