RXINSIDER 2025
Blue Cross Vision – Optics Vision 130-24 Eye Med
BCBS Vision Care Bene�ts
Vision Care Services
In-Network Cost
Out-of-Network Cost
Exam (With Dilation as Necessary)
$10/Copay
Up to $35
Contact lens �t and follow-up visits are
available once a comprehensive eye exam
has been completed.
Standard Contact Lens Fit and Follow-Up
Up to $40/Copay
10% Off Retail Price
N/A
Standard Plastic Lenses
Single Vision
Bifocal
Standard Progressive
$25/Copay
$25/Copay
$90/Copay
Up to $25
Up to $40
Up to $40
Frames
$0 Copay; 20% Off Balance
Over $130 Allowance
Up to $65
Frequency
Examination
Lenses or Contact Lenses
Frames
Once Every 12 Months
Once Every 12 Months
Once Every 24 Months
Once Every 12 Months
Once Every 12 Months
Once Every 24 Months