The vision plan covers you and your covered dependents for routine eye exam, frames, and lenses or contacts. You can choose to visit any provider; however, you will save money when you visit an in-network provider. Find an in-network provider at my.cigna.com or call (800) 244-6224.
| Plan Features | Cigna Vision Plan | |
|---|---|---|
| In-Network | Out-of-Network | |
| You pay: | Plan reimburses you: | |
| Exam every 12 months | $10 copay | Up to $45 |
| Frames every 12 months | 20% of amount above $150 allowance | Up to $83 |
| Lenses every 12 months Single Vision Bifocal Trifocal Lenticular |
$10 copay | Up to $32 Up to $55 Up to $65 Up to $80 |
| Contact Lenses every 12 months (in lieu of lenses and frames) Conventional Medically Necessary |
Any amount above $150 allowance Covered in full |
Up to $120 Up to $210 |
See the Benefits Guide or benefit summaries for detailed information.
Your per pay period payroll deductions are shown in the table below.
| Coverage Level | Cigna Vision Plan |
|---|---|
| Employee Only | $3.77 |
| Employee + Spouse/DP | $7.17 |
| Employee + Child(ren) | $7.54 |
| Employee + Family | $11.09 |
Interested in laser vision correction services, such as LASIK? Visit my.cigna.com and search for Healthy Rewards for details.