Benefits include oversize lenses, blended invisible bifocals, certain fashion frames and sun tinting of plastic lenses, gradient tints, glass gray #3 prescription sunglasses, and initial lenses following cataract surgery. Materials carry a one-year warranty against breakage. Discounts are available for nonprescription and additional prescription glasses.

Covered Services The Vision Plan covers the following services once each calendar year.
Service/Supply Plan Benefits1	Davis Vision Provider Maximum Benefit Payment	Non-Davis Vision Provider Maximum Benefit Payment
Comprehensive eye exam Routine eye examinations may not include professional services for contact lens evaluations. Any applicable fees are the responsibility of the patient.	Covered in full	$30
Single-vision lenses	Covered in full	$25
Bifocal lenses	Covered in full	$35
Trifocal lenses	Covered in full	$45
Eyeglass frames	Fashion, designer, and premier collections covered in full or receive a $50 credit toward a network provider’s own frame	$30
Scratch resistant coating	Covered in full	N/A
Blended invisible bifocals	Covered in full	N/A
Ultraviolet (UV) coating	Covered in full	N/A
Contact lenses in lieu of eyeglasses2 3
Standard, soft, daily wear, disposable or planned replacement** contact lenses may be selected in lieu of eyeglasses.4	Covered in full	$75
Non-plan contact lenses	$105 retail credit will be applied toward contact lenses from the Davis Vision provider’s own supply	N/A

¹ Benefits include oversize lenses, blended invisible bifocals, certain fashion frames and sun tinting of plastic lenses, gradient tints, glass gray #3 prescription sunglasses, and initial lenses following cataract surgery. Materials carry a one-year warranty against breakage. Discounts are available for additional prescription glasses. Ask your provider if they are willing to extend a discount on non-prescription eyewear.

² Contact Davis Vision to verify that your brand of contacts is covered before you enroll.

³ Please note: Contact lenses can be worn by most people. Once the contact lens option is selected and the lenses are fitted, they may not be exchanged for eyeglasses.

⁴ ** Standard daily wear soft lens users will receive one pair of lenses. Disposable contact lens wearers will receive four multi-packs of lenses. Planned replacement contact lens wearers receive two multi- packs of lenses.