How It Works   Plan Overview   Certificate of Benefits     Contact Information   Copayment for each member at the time of service Exam: $10 Lenses and/or frames: $15   Network Doctor (After copayments/ up to plan limits) Non-network Eye Exam Paid in full $45 Lenses (per pair)      Single Paid in full $30  Bifocal Paid in full $50  Trifocal Paid in full $70  Lenticular Paid in full $100 Contact Lenses     Elective (fitting, follow-up & lenses)** $120 $120 Medically necessary* Paid in full $150 Frame Paid in full $50