Blue View Vision

Your Blue View Vision network
Anthem Blue Cross and Blue Shield vision members have access to one of the nation’s largest vision networks. Blue View Vision is the only vision plan that gives members the ability to use their in- network benefits at 1-800 CONTACTS, or choose a private practice eye doctor, or go in store to LensCrafters®, Sears OpticalSM, Target Optical®, JCPenney® Optical and most Pearle Vision® locations. Out-of-network: If you choose to, you may receive covered benefits outside of the Blue View Vision network. Just pay in full at the time of service, obtain an itemized receipt, and file a claim for reimbursement of your out-of-network allowance. In-network benefits and discounts will not apply.

YOUR BLUE VIEW VISION PLAN AT-A-GLANCE

Covered benefits NETWORK OUT-OF-NETWORK

Routine eye exam once every 12 months

$15 copay

$15 allowance

Eyeglass frames

Once every 12 months you may select an eyeglass frame and receive an allowance toward the purchase price

$100 allowance, then 20% off any remaining balance

$30 allowance

Eyeglass lenses (Standard)

Once every 12 months you may receive any one of the following lens options:

  • Standard plastic single vision lenses (1 pair)

$0 copay

$10 allowance

  • Standard plastic bifocal lenses (1 pair)

$0 copay

$20 allowance

  • Standard plastic trifocal lenses (1 pair)

$0 copay

$30 allowance

  • Standard plastic lenticular lenses (1 pair)

$0 copay

$40 allowance

Eyeglass lens enhancements

When obtaining covered eyewear from Blue View Vision provider, you may choose to add any of the following lens enhancements at no extra cost.

$0 copay

No allowance on lens enhancements when obtained out-of-network

  • Transitions Lenses (for a child under age 19)

  • Standard Polycarbonate (for a child
  • Factory Scratch Coating

Contact lenses - once every 12 months

Prefer contact lenses over glasses? You may choose contact lenses instead of eyeglass lenses and receive an allowance toward the cost of a supply of contact lenses.

  • Elective Conventional Lenses; or

$100 allowance, then 15% off any remaining balance

$40 allowance

  • Elective Disposable Lenses; or

$100 allowance (no additional discount)

$40 allowance

  • Non-Elective Contact Lenses

$200 allowance (no additional discount)

$75 allowance

Contact lens allowance will only be applied toward the first purchase of contacts made during a benefit period. Any unused amount remaining cannot be used for subsequent purchases in the same benfit period, nor can any unused amount be carried over to the following benefit period.

BLUE VIEW VISION MEMBER EXCLUSIVE!

You may use your in-network benefit to order your contact lenses from 1-800 CONTACTS.
1-800 CONTACTS offers a huge in-stock inventory, unbeatable prices, outstanding customer service and free shipping.
Just call 1-800 CONTACTS or go to 1800contacts.com for fast and easy ordering of your contact lenses.


Exclusions & Limitations (not a comprehensive list)

Combined Offers. Not to be combined with any offer, coupon, or in-store advertisement.
Excess Amounts. Amounts in excess of covered vision expense.
Sunglasses.Sunglasses and accompanying frames.
Safety Glasses. Safety glasses and accompanying frames.
Not Specifically Listed. Services not specifically listed in this plan as covered services.
Orthoptics. Orthoptics or vision training and any associated supplemental testing.

Lost or Broken Lenses or Frames. Any lost or broken lenses or frames are not eligible for replacement unless the insured person has reached his or her normal service interval as indicated in the plan design.
Non-Prescription Lenses. Any non-prescription lenses, eyeglasses or contacts. Plano lenses or lenses that have no refractive power. Orthoptics. Orthoptics or vision training and any associated supplemental testing.

OPTIONAL SAVINGS AVAILABLE FROM IN-NETWORK PROVIDERS ONLY

In-network Member Cost (after any applicable copay)

Retinal Imaging - at member's option can be performed at time of eye exam

Not more than $39

Eyeglass lens upgrades

When obtaining eyewear from a Blue view Vision provider, you may choose to upgrade your new eyeglass lenses at a discounted cost. Eyeglasses lens copayment applies.

  • Transitions lenses (Adults)

$75

  • Standard Polycarbonate (Adults)

$40

  • Tint (Solid and Gradient)

$15

  • UV Coating

$15

  • Progressive Lenses (1)

    • Standard

$65
    • Premium Tier 1

$85
    • Premium Tier 2

$95
    • Premium Tier 3

$110
  • Anti-Reflective Coating (2)

    • Standard

$45

    • Premium Tier 1

$57

    • Premium Tier 2

$68

  • Other Add-ons and Services

20% off retail price

Additional Pairs of Eyeglasses

Anytime from any Blue View Vision network provider

  • Complete Pair

40% off retail price

  • Eyeglass material purchased separately

20% off retail price

Eyewear Accessories

  • Items such as non-prescription sunglasses, lens cleaning supplies, contact lens solutions, eyeglass cases, etc.

20% off retail price

Contact lens fit and follow-up

A contact lens fitting and up to two follow-up visits are available to you once a comprehensive eye exam has been completed

  • Standard contact lens fitting (3)

Up to $55

  • Premium contact lens fitting (4)

10% off retail price

Conventional Contact Lenses

  • Discount applies to materials only

15% off retail price

SOME OF THE ADDITIONAL SAVINGS AVAILABLE THROUGH OUR SPECIAL OFFERS PROGRAM

1-800 CONTACTS

After your benefits for the coverage period have been used, you can save on contact lenses with this offer. (5)

  • For this and other great offers, login to member services, select discounts, then Vision, Hearing & Dental

Save $20 on orders of $100 or more and get free shipping

Laser vision correction surgery

LASIK refractive surgery.

  • For this and other great offers, login to member services, select discounts, then Vision, Hearing & Dental

Discount per eye

Please ask your provider for his/her recommendation as well as the progressive brands by tier. Please ask your provider for his/her recommendation as well as the coating brands by tier. A standard contact lens fitting includes spherical clear contact lenses for conventional wear and planned replacement. Examples include but are not limited to disposable and frequent replacement. A premium contact lens fitting includes all lens designs, materials and specialty fittings other than standard contact lenses. Examples include but are not limited to toric and multifocal. Discount cannot be used in conjunction with your covered benefits.

OUT-OF-NETWORK

If you choose an out-of-network provider, please complete an out-of-network claim form and submit it along with your itemized receipt to the fax number, email address, or mailing address below. When visiting an out-of-network provider, discounts do not apply and you are responsible for payment of services and/or eyewear materials at the time of service.

Contact:

To Fax: 866-293-7373
To Email: oonclaims@eyewearspecialoffers.com
To Mail:
Blue View Vision
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111

Blue View Vision is for routine eye care only. If you need medical treatment for your eyes, visit a participating eye care physician from your medical network. If you have questions about your benefits or need help finding a provider, visit anthem.com or call us at 1-866-723-0515.

This is a primary vision care benefit intended to cover only routine eye examinations and corrective eyewear. Benefits are payable only for expenses incurred while the group and insured person’s coverage is in force. This information is intended to be a brief outline of coverage. All terms and conditions of coverage, including benefits and exclusions, are contained in the member’s policy, which shall control in the event of a conflict with this overview. Discounts referenced are not covered benefits under this vision plan and therefore are not included in the member’s policy. Laws in some states may prohibit network providers from discounting products and services that are not covered benefits under the plan. Frame discounts may not apply to some frames where the manufacturer has imposed a no discount policy on sales at retail and independent provider locations. Discounts are subject to change without notice. This benefit overview is only one piece of your entire enrollment package.

Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

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