Vision Care Plan
The District's vision care plan is covered by the Excellus BlueCross BlueShield 20/20 Vision Care Plan. If you receive this benefit, here's an overview of what is covered.
| Service | Allowance | Time Frame |
| Eye Exam | $30 | once in 12 months |
| Referral Eye Exam | $30 | upon referral by an optometrist to an ophthalmologist within 60 days of the initial exam |
| Frames | $25 | once in 12 months |
| Lenses (per pair) | once in 12 months |
| Single Vision | $30 |
| Bifocal | $50 |
| Trifocal | $65 |
| Aphakic | $105 |
| Contacts | once in 12 months |
| Medically Necessary | $200 |
| Cosmetic | $55 |
How You Receive Payment
When you visit your provider, present your 20/20 Vision Care ID Card. A participating provider will submit a Vision Care claim form and will receive payment directly from Excellus BlueCross Blueshield. You owe the balance of the charge.
When visiting a non-participating provider, bring a Vision Care claim form (see below) and ask the provider to fill out the bottom section. Attach a copy of the itemized bill/receipt and submit it to Excellus. Payment will be made to you.
Exclusions
The following expenditures are not covered under the Vision Care Plan:
- Any lenses which do not require a prescription and are not medically necessary, such as non-prescription sunglasses
- Replacement of lost, stolen, broken, or damaged lenses, contact lenses, or frames
- Industrial safety glasses and goggles
- Eye examinations or materials required by the subscribers employment or furnished as a condition of employment
- Costs of services for which a government agency or program is liable
- Any service or time not explicitly designated as a contract benefit in the Vision Care contract.
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