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2019 Vision Plan

Plan Type
Vision

The Vision Plan is a preferred provider organization (PPO) plan where costs are less if you use in-network services. Providers outside of the network can be accessed without a referral for an additional cost.

Features
  • Low contribution cost with no annual deductible or out-of-pocket maximum (OPM).
  • Receive a comprehensive vision exam every year.
  • Get two pairs of prescription eyeglasses or one pair of prescription eyeglasses and an allowance toward contact lenses or double the contact lens allowance every calendar year.
  • Coverage for tints, polycarbonate lenses, and scratch coatings. 
  • Discount on laser vision correction surgery.
Coverage Options
In-Network
Out-of-Network
Plan Design
Employee
$15.16
Employee & Children
$24.83
Employee & Spouse
$24.38
Family
$40.04
Exam (Once every calendar year)

Comprehensive Vision Exam

In-Network
$10 copayment
Out-of-Network
100% with reimbursement up to $45
Prescription Lenses (Once every calendar year)

Single Vision

In-Network
$10 copayment / Applied to lenses and frames / If purchasing lenses and frames together, one $10 copayment applies
Out-of-Network
100% with reimbursement up to $30

Lined Bifocals

In-Network
$10 copayment / Applied to lenses and frames / If purchasing lenses and frames together, one $10 copayment applies
Out-of-Network
100% with reimbursement up to $50

Progressives

In-Network
$10 copayment / Applied to lenses and frames / If purchasing lenses and frames together, one $10 copayment applies
Out-of-Network
100% with reimbursement up to $50

Lined Trifocals

In-Network
$10 copayment / Applied to lenses and frames / If purchasing lenses and frames together, one $10 copayment applies
Out-of-Network
100% with reimbursement up to $65

Lenticular

In-Network
$10 copayment / Applied to lenses and frames / If purchasing lenses and frames together, one $10 copayment applies
Out-of-Network
100% with reimbursement up to $100
Frames (Once every calendar year)

All

In-Network
100% with coverage up to $155 after a $10 copayment / 100% with coverage up to $85 after a $10 copayment at Costco, Walmart, or Sam's Club / If purchasing lenses and frames together, on $10 copayment applies
Out-of-Network
100% with reimbursement up to $70
Prescription Contact Lenses (Once every calendar year)

Evaluation Fees

In-Network
Copayment not to exceed $60
Out-of-Network
Not covered

Fitting Costs

In-Network
Copayment not to exceed $60
Out-of-Network
Not covered

Materials

In- or Out-of-Network
100% reimbursement up to $140
Additional Information

All benefits-eligible employees can elect coverage under the Vision Plan except Visiting Fellows.

ID cards will be mailed to home addresses within three to four weeks following enrollment in or changes to medical coverage. ID cards can also be viewed on the provider’s website or app.

Disclaimer

If there are any discrepancies between the information in this publication, verbal representations, and the plan documents, the plan documents always govern. Although Princeton intends to continue these benefits, the University reserves the right to amend or terminate these plans at any time.