Group Number
00577938
Provided By
Guardian
Provider Website
Customer Service
Vision Benefits
Vision insurance offers coverage for the routine care of your eyes and may provide coverage for eyeglasses and contact lenses. Your plan will pay for these services based upon the schedule below. Be sure to check your plan certificate for details.
Keep in mind that your costs will generally be lower if you choose an in-network eye-doctor. To find an in-network eye-doctor, please visit www.guardianlife.com.
In-Network |
Out-of-Network |
|
|---|---|---|
Exam |
$10 |
$59 allowance |
Standard Plastic Lenses |
||
Single |
$25 Copay |
$30 allowance |
Lined Bifocal |
$25 Copay |
$50 allowance |
Lined Trifocal |
$25 Copay |
$65 allowance |
Lenticular |
$25 Copay |
$100 allowance |
Frames |
$130 allowance + 20% off amount over allowance |
$70 allowance |
Contact Lenses |
$25 Copay |
$210 allowance |
Dependent Age Limit |
26 |
26 |
Frequency |
||
Exam |
Every calendar year |
Every calendar year |
Lenses |
Every calendar year |
Every calendar year |
Frames |
Every two calendar years |
Every two calendar years |
Per Pay Period Rate |
|
|---|---|
Employee |
$1.40 |
Employee + Spouse |
$2.85 |
Employee + Child(ren) |
$2.40 |
Family |
$4.00 |
Group Number
00577938
Provided By
Guardian
Provider Website
Customer Service