Vision Plan at a Glance

Here’s a look at what’s covered and what you pay. You can see any provider, but you will save money when you use BCBS of TX/EyeMed in-network providers. Find an in-network provider by calling 855-556-8796 or visit eyemedvisioncare.com/bcbxtxvis. You can also print a vision ID card on the site.

Vision Plan
In-network Out-of-network1
You pay
Exam with dilation (Once per calendar year) $10 copay All amounts over $40
Frames (Once per calendar year) $0, then all amounts over $2002 All amounts over $45
Lenses3 (Once per calendar year)
Single vision $20 copay All amounts over $40
Bifocal $20 copay All amounts over $60
Trifocal $20 copay All amounts over $80
Lenticular $20 copay All amounts over $80
Contact Lenses (in lieu of eyeglasses; once per calendar year)
Standard contact lens fit and follow-up You get a 15% discount No discount
Visually required contacts $0 (must get prior approval) All amounts over $210
Conventional or disposable contacts $0, then all amounts over $1504 All amounts over $150
  1. When you use an out-of-network provider, you must pay the cost up-front and then file a claim to be reimbursed up to the out-of-network allowance.
  2. You get a 20% discount on all amounts over the plan allowance.
  3. The plan will pay 100% for polycarbonate lenses, scratch-resistant coating, UV coating and tinting. There is an additional charge for some lens options such as some anti-reflective coatings, some progressive lenses, polarized lenses and photochromic lenses.
  4. You get a 15% discount on all amounts over the plan allowance.

Paycheck Costs

Here are your premium costs for the Vision Plan.

Vision Plan
Bi-weekly Monthly
Employee only $3.13 $6.79
Employee and children $6.59 $14.27
Employee and spouse $6.27 $13.59
Family $9.17 $19.87