Charlotte County Public Schools


 

  Dental Options

  CS150 DHMO Overview
  CS150 DHMO Schedule of Benefits

  CS150 DHMO FAQs

  Search for Providers
  AVF1 Overview
  AVF1 Schedule of Benefits
  AVF1 FAQs

  Search for Providers
  Elite 710 w/ortho Overview
  Elite 710 w/ortho Schedule of Benefits

  Elite 710 w/ortho FAQs

  Elite 710 w/ortho Certificate

  Search for Providers
  Claim Form

  Vision Option

  Overview
  Certificate of Coverage - In Network
  Certificate of Coverage - Out of Network
  LASIK Benefits
 

 Dental/Vision Members

  MyCompBenefits
  Contact Information
 


Plan Frequencies Exam every 12 months
Lenses every 12 months
Frames every 24 months

Copayment for each member at the time of service
Exam: $10
Materials: $15

Maximum Allowances Network Doctor
(After copayments/Up to plan limits)
Non-network
(copayments apply)
     
Eye Exam Paid in full $35
Lenses (per pair)    
Single Paid in full $25
Bifocal Paid in full $40
Trifocal Paid in full $60
Lenticular Paid in full $100
Contact Lenses    
Elective (exam & lenses)** Exam plus $105 Exam plus $105
Medically necessary* Paid in full $210
Frame $45 wholesale $45 retail