Adult Routine Vision

Frames

• Limited to 1 pair of frames every calendar year (up to a $150 allowance)

Lenses

• Limited to 1 pair every calendar year
• Glass or plastic single vision, lined bifocal, lined trifocal or lenticular lenses

• In lieu of prescription glasses, materials and services are limited to 1 pair of contact lenses up to $150 every calendar year.
• Medically necessary contact lenses for specified medical conditions require Prior Authorization.