Tampa General Hospital


 

  Vision Option

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

Vision Members

  MyCompBenefits
 


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
Lenses and/or frames: $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 $20
Bifocal Paid in full $40
Trifocal Paid in full $60
Lenticular Paid in full $100
Contact Lenses    
Elective (exam & lenses)** Exam + $120 Exam + $120
Medically necessary* Paid in full $150
Frame $45 wholesale $45 retail