Jump to: Exams, Lenses and Frames | Contact Lenses | Other Services
| SERVICE TYPE | NETWORK | NON-NETWORK | ||
|---|---|---|---|---|
| BASIC PLAN | PREMIUM PLAN | ULTRA PLAN | ||
| Exams | Once every calendar year — two annual exams covered for children up to age 18 | |||
| $10 copayment | $10 copayment | $10 copayment | NVA pays up to $45 | |
| Lenses | Once every calendar year Single-vision, bifocal, trifocal, lenticular (see website for other types of lenses and cost sharing) | |||
| $25 copayment | $25 copayment | $25 copayment Lens includes scratch coating, UV protection, Polycarbonate, tints, AR coating (tier 1) & Progressive Lenses Tiers 1 & 2 | Maximum amount NVA pays varies based on type of lenses | |
| Frames | Once every two calendar years, once every calendar year up to age 18 | |||
| Up to $125 retail allowance and 20% discount off remaining balance | Up to $175 retail allowance and 20% discount off remaining balance | Up to $175 retail allowance and 20% discount off remaining balance | NVA pays up to $70 | |
| Contact Lenses – Elective (You prefer contacts to glasses.) | Once every calendar year in place of eyeglass lenses | |||
| Up to $125 retail allowance and 15% discount off conventional or 10% discount off disposable remaining balance | Up to $175 retail allowance and 15% discount off conventional or 10% discount off disposable remaining balance | Up to $175 retail allowance and 15% discount off conventional or 10% discount off disposable remaining balance | NVA pays up to $105 | |
| Contact Fitting and Evaluations | For daily contact lenses, extended contact lenses and specialty contact lenses | |||
| $20 to $50 copayment depending on type of lenses | $20 to $50 copayment depending on type of lenses | $0 Copayment | NVA pays up to $20 to $30 depending on type of lenses | |
National Vision Administrators administers the vision plan. To view the plan’s full benefit summaries, please visit NVA’s website.
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