Orlando Health Inc.
 
  How It Works
  Plan Overview
  Lasik Benefits
  Certificate of Benefits
 

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


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
Polycarbonate lenses
Paid in full N/A
Transition lenses
Paid in full N/A
Progressive lenses 1, 2, and 3
Paid in full N/A
Contact Lenses  
Elective (exam & lenses) Exam +
$ 105**
Exam +
$ 105**
Medically necessary* Paid in full $210
Frame $45 wholesale $45 retail
Lasik*** Members will receive a discount if services are rendered by a TLC Network provider and they will pay no more than $1800/eye. No benefit
  Discount Only No Benefit