Vision Benefits

Name: Fashion, Inc.
Address: United States

	In-Network	Out-of-Network	Frequency
Eye Exam	$10 Copay	Up to $40	Once every plan year
Lenses Single Lined Bifocal Lined Trifocal Lined Lenticular	Material Copay	Up to $30 Up to $50 Up to $70 Up to $70	Once every plan year
Frames	20% off balance over $150 allowance	Up to $105	Once every plan year
Contact Lenses	15% off balance over $150 allowance	Up to $105	Once every plan year (in lieu of lenses)

Provided By

Blue Cross Blue Shield of Kansas
EyeMed/Insight Network

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Customer Service

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