Vision

Healthy eyes and clear vision are an important part of your overall health and quality of life.

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

Plan Information

Plan Name: Cigna Vision

Policy Number: 17329049

Effective Date: 01/01/2025 

Network: Cigna Vision 

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
$0 

Single Vision Lenses
Covered 100% after copay 

Bifocal Lenses
Covered 100% after copay 

Trifocal Lenses
Covered 100% after copay 

Frames
Up to $140 

Contacts (in lieu of glasses)
Up to $140 

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams
Up to $45 reimbursement 

Single Vision Lenses
Up to $40 reimbursement 

Bifocal Lenses
Up to $65 reimbursement 

Trifocal Lenses
Up to $75 reimbursement 

Frames
Up to $91 reimbursement 

Contacts (in lieu of glasses)
Up to $125 reimbursement 

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Contact Information

Cigna Vision Tier 2

Plan Information

Plan Name: Cigna Vision Tier 2

Policy Number: 17329049

Effective Date: 01/01/2025 

Network: Cigna Vision 

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 

Single Vision Lenses
Covered 100% after copay 

Bifocal Lenses
Covered 100% after copay 

Trifocal Lenses
Covered 100% after copay 

Frames
Up to $130 

Contacts (in lieu of glasses)
Up to $130 

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams
Up to $45 reimbursement 

Single Vision Lenses
Up to $40 reimbursement 

Bifocal Lenses
Up to $65 reimbursement 

Trifocal Lenses
Up to $75 reimbursement 

Frames
Up to $78 reimbursement 

Contacts (in lieu of glasses)
Up to $115 reimbursement 

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Contact Information