Orange County NC Website
Browse       Search
D <br />nt <br /> ~ T Odra e <br /> <br /> • <br />. m <br />~ <br />'. <br />_ _ Oi~age~Cryi~nty Gci~ernment- Vision P•rogram•Gai'~parison cn <br />- . '- _ <br />~ • • • Preparei~ bjr tv~ark•I(i 1=mptayee 8etre~s . <br />-August 21.3. ~ ~ ~ <br />I <br />. .. <br />' .- Su iarlresian=H' . Cflmmtuf~ eCdre-H' h.• .. Ameri~s/>: eNlcd-~Fti h <br />( <br />•. Pfan <br />DesiRn _ <br />• fn-Pletwork Out-of-F~2etwork tn-Network Ourio~Pte2sevark in-Network Out-af Netwarlc <br />• Exam,F v . eve :~ rrtarr~s eve ~ montfis <br />' a 12 rawrrt'^s' ev 12 months eve 1Z mors~rs ev 12 months + <br />Ca~paymeat for eye exam S10.oo Re <br />rrnbursed up to <br />$39 <br />520.130 <br />$20.00 <br />S(} <br />a% <br /> <br />_ - Up to S'~ <br />Ca me for materraf <br />- <br />• S].0.00 $10.00 $0.00 $0.00 S0.0o 50 <br />00 <br />• <br />Frame : <br />aencv ~ eve 24 months ev 24 snareths eve. 72 maritf~ eve f2 months eve 2~ rran:,hs , <br />eve 24 ma'tt <br />~s <br />Frarrte affawartoe levered up to Sl?0 reta0 up to S'77 Up to 57.50 allavrdrtre Up to $150allowartce*"'* covered Up to 5130 retail . <br />up to 56S <br />Lens~re en <br />~resAllawance . . a I2 months eve 32 months every ].2 mouths eve i2 montfu every I2 :ron~ts eve ~ r:tarrths I <br />' - . ,Single ~~isi <br />• Covered In Fu11 Up i+o S84 Up to $]a'0 aP.owa»ce U p tQ $7S0 aAawance'"** Covered in 1~,111 Up to 525 I <br />- ' . Bifac2 Covered in Full ilp to $4S Upto $].54 al3owantae Upto 51SOallovrance"*" Covered in Fv[I Upta Sta ~ <br />. Trifara Covered ira >'up Up'to S6a Upto $]SO allavrarlcc Up t4 $7SOaHowance'""'~ Covered irc ~~fl Ugta $55 <br />• - Lenticula <br />- Cavierec In full Up to $8& Up to 5150 ~llotr+ance Up to $150allowarrce*~" 20% dlscaur~t t~tot Covered <br />~ Pragressev <br />. Covered as'Frfaca[ Up to $64 Up trs 5150 allowance <br />~ Up tv 5350 a1lov+ra:lCe**'~ Capay..: Sfi~ zro~aovered ~ 1 <br /> <br />" <br />" PolyKarbo~2te-$40 f~ofyrarisonate-$40 <br /> <br />-ptionai <br />Add-4ns <br />Max;inum <br />• • C6arge• <br />StrtthCoating-S'-'3 <br />Arrti-Fteffective - S50 <br />taaBenefit <br />Upto$150allovrance <br />Upta$154altgwance"*" <br />~~'$~ i <br />1 <br /> <br />. - <br />UV Coa~ng - 535 Anti-Refie~;ve -S45 Na Se.~~ ~ <br /> W Caa~ng ~ $15 ~ . <br />Contact lens allavrance ~ <br />. - Eyety 1.2 morrtlts <br />med+ca[[y necessary - full, medicaiy+ nec~*ssary - up <br />m 5220, elective - up to <br />Up ~ 5150 allowance <br />Up to 5154 allowance""" Every 32 manThs, <br />medically necessary -full medically necessary_ up i <br />to $z00 <br />elective - u <br />~ ~ <br />- <br /> <br />' elective - u tc3 S150 S1U0 , <br />elective - u fici 5130 , <br />p <br />~j <br />~yq <br />• <br />Gontad•Eerts•Fittistx•Fee S25At} NotCavered SZ0.00 Nat Covered Nave . <br />~ <br />~ <br /> <br /> <br />• 8efr-acesreEyeSurgery <br />piswurrixtNetwork <br /> <br />Nat Covered <br />Slsgaurf~artNetv~rork <br />NotCgwered <br />D'~sc:octntat~le:,voork 3 <br />are <br />~ <br />` <br /> Providers Providers PrOvlc>ers MotCaverad ; <br />' <br />.. <br />Providers <br />' ~~"""~''~'-~'pertorofsian.camforacomptetetsting Ifstt~vww_eammurrtiyeyecare.net~oraoomplets <br />' - <br />~s~www.atrceripsgroup.camfar3carz~pietel'astirg <br />• • a~ roviders E <br />isGn of rovlders afproviders <br />Partiapa#ion Regwire;nent None Norte <br /> <br />. '-Fir1Hr1C131 ttating,_AN! Best <br />A- National ~uardlan life <br />IVn?RiraA _ Rinw a,. i.ee...y,..,..~ r.. No rte f <br /> <br />• m ee+• <br />E <br />1 + F <br />•' <br />518.80 <br />$18.54 v: <br />Err: Ea ee/5 use-5 <br />m <br />Om; 527.60 $27.30 Ern to a/ChIC .yen - <br /> <br />Premium Stabtl'~zaGOn <br />Na ~ <br />Na • Frnp1 /famlfY - 5 <br /> <br />• RaceGvarantee • <br />-- __- years <br />a,.m~.r yes <br /> <br />