Blue Cross Blue Shield FEP Vision
Section 5 Vision Services and Supplies
        
        
        
    Section 5 Vision Services and Supplies
Diagnostic
        
            Benefit Description
Vision Care Exam: covered in full once every calendar year.
 
BCBS FEP Vision doctors provide a comprehensive exam that focuses on your eye health and overall wellness
High Option – You Pay
In-Network: Nothing
Out-of-Network: Expenses in excess of the fee schedule allowance of $30
Standard Option – You Pay
In-Network: Nothing
Out-of-Network: All charges
        
        
        
    Vision Care Exam: covered in full once every calendar year.
- Includes dilation, if professionally indicated
 
- Includes refraction only if vision health exam is billed to medical
BCBS FEP Vision doctors provide a comprehensive exam that focuses on your eye health and overall wellness
High Option – You Pay
In-Network: Nothing
Out-of-Network: Expenses in excess of the fee schedule allowance of $30
Standard Option – You Pay
In-Network: Nothing
Out-of-Network: All charges
            Benefit Description
Retinal Imaging
High Option – You Pay
In-Network: $39 copay
Out-of-Network: All charges
Standard Option – You Pay
In-Network: $39 copay
Out-of-Network: All charges
        
        
        
    Retinal Imaging
High Option – You Pay
In-Network: $39 copay
Out-of-Network: All charges
Standard Option – You Pay
In-Network: $39 copay
Out-of-Network: All charges
