Description
Vision Benefit Guide for Savings Account Members
Vision Examinations
| Routine Vision Exam | 45.00 |
| Contact Lens Exams | Usual and Customary Fees |
Contact Lenses
Benefits will be applied to the Usual and Customary Fees for all Contact Lens Purchases
Frames
Benefit members will be charged a base rate of 45.00 for any frame not exceeding 119.00.
Any frame with a retail price over the allowance of 119.00, the difference will be added to the base rate.
Lenses
| Single Vision Basic Plastic Clear | 30.00 |
| FT 28 Bifocal Basic Plastic Clear | 55.00 |
| 7X28 Trifocal Basic Plastic Clear | 65.00 |
| Progressive No-Line Bifocal Basic Plastic Clear | 75.00 |
(No-Line Brands Include: Image, Adage, Instinctive, Small Fit and Shore View Mini)
Available Lens Options
(Add to Base Lens Cost)
| Polycarbonate Upgrade (No Additional Upgrade Cost for Children Under 18) | 30.00 |
| 1.67 High Index Thin and Lite Upgrade | 55.00 |
| Trivex Premium Lens Upgrade | 40.00 |
| Photochromic Plastic Upgrade Single Vision | 65.00 |
| Photochromic Plastic Upgrade Multifocal | 85.00 |
Anti-Reflective Non-Glare:
| Peak Basic Non-Glare | 45.00 |
| Sync Super Hydrophobic | 65.00 |
| Supreme Super Hydrophobic, Anti-Static and Smudge Resistant | 99.00 |
| Polarized Non-Glare Sun (Nu-Polar) | 65.00 |
| Basic Custom Tinting or Ultraviolet 400 | 30.00 |
| Custom Edge Polishing | 25.00 |
Disclosure
R & R Optical Inc. dba Wise Eyes Optical, reserves the right to cancel any vision care program it represents at their discretion. The Vision Savings Program can be cancelled by the member at any time without penalty for fee. Any remaining funds will be paid back to the primary listed benefit member or beneficiary thereof. All pricing listed in this program is subject to change without notice to any benefit member. Any returns or remakes must be requested before 30 days, after 30 days any returns or remake requests will be the responsibility of the member. Refunds are subject to a 25% restocking fee after the 30-day expiration. Benefit members can use the pricing of the benefit guide at any time of requested service if account remains valid with funds. Benefits cannot be given to any other person without notice or agreement of the primary member.
