Vision

Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.

Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.

Cigna Vision serviced by EyeMed

Plan Information

Plan Name: Cigna Vision (C1 PPO Comprehensive Plan)

Policy Number: 655868

Effective Date:  01/01/2025 

Network:  EyeMed

In-Network Benefit Highlights

Deductible (Individual/Family)
$XX/$XX

Out-of-Pocket Max (Individual/Family)
$XX/$XX

Preventive Care
$XX

Primary Care Visit
$XX

Specialist Visit
$XX

Urgent Care
$XX

Emergency Room
$XX

Benefit Highlights

In-Network

Exams 
$10 copay  

Single Vision Lenses 
$25 copay  

Bifocal Lenses 
$25 copay 

Trifocal Lenses 
$25 copay 

Frames 
$25 copay up to a $150 allowance  

Contacts (in lieu of glasses) 
$25 copay up to a $150 allowance  

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams 
Up to $40 reimbursement 

Single Vision Lenses 
Up to $40 reimbursement 

Bifocal Lenses 
Up to $60 reimbursement 

Trifocal Lenses 
Up to $80 reimbursement 

Frames 
Up to $45 reimbursement 

Contacts (in lieu of glasses) 
Up to $150 reimbursement 

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Contact Information