How to use the OPTIX vision panel plan benefits

1. A list of participating optometrists and ophthalmologists is in the Optix Vision Provider Directory. Benefits listed are valid at all participating eye doctors.
    
2. Identification cards are not needed. Your eligibility for service is verified by identifying yourself as an Optix Panel Plan participant when you make an appointment with a participating eye doctor.
    
3. The eye doctor's office will handle all claim forms.

Important notes to remember:

1. The eye exam, contact lens (new or replacement), and lenses are provided once every plan year regardless of prescription change. Frames are provided every two years if the doctor determines they are necessary.
    
2. Your out-of-pocket cost for the service rendered is paid by you upon receipt of services. Oversize lenses, tinted lenses, sunglasses, nonstandard and photochromatic lenses may be purchased with an additional charge. Contact lenses are in lieu of frames and lenses. Fitting fees for contact lenses are not included.†
    
3. Certain therapeutic and diagnostic procedures are available to the participants of Optix on a co-payment basis. See you certificate of insurance for a list of these procedures. There is no annual deductible with this plan.

How to use the OPTIX vision non-panel plan benefits

1. Optix Vision Non-Panel Plan benefits are valid at any licensed ophthalmologist, optometrist or optician, who is not an Optix plan provider.
    
2. Vision care claim forms are available at your worksite or will be provided upon request by calling Optix Vision Plan - For Miami-Dade County Government: 1-800-EYE-CURE · 1-800-393-2873
   For Jackson Health System Employees: 1-800-342-8017

Important notes to remember:

1. You are responsible for payment of the entire fee. There will be a reimbursement by the Optix Vision Non-Panel Plan up to the amounts listed on the previous page.
    
2. The vision exam is provided once every plan year: maximum $40 reimbursement.
    
3. Lenses are provided once every plan year, if needed as determined by your optometrist or ophthalmologist.
    
4. Frames are provided every two years if needed. Frames are limited to a maximum of a $40 reimbursement.
    
5. Contact lenses will be provided once every plan year* under the plan if needed, as determined by your optometrist or ophthalmologist. Payment will be made for only one pair of lenses, either single, bifocal, trifocal, or contacts during a plan year. Benefits are not payable for contact lens fitting charges. No frame or lens benefits are available during the plan year that contact lenses are elected.**

This product description does not constitute an insurance certificate or policy. The information provided is intended only to assist in the selection of benefits. Final determination of benefits, exact terms and exclusion of coverage for each benefit plan are contained in certificates of insurance issued by the participating insurance companies.

* Benefits will be on the calendar year, not the effective date of coverage.

** Not applicable with any other promotion. Does not apply to sale items or other discounted products.