Vision Benefits
Keep in mind that your costs will generally be lower if you choose an in-network eye-doctor. To find an in-network eye-doctor, please visit deltadentalmo.com/vision.
In-Network |
Frequency |
|
|---|---|---|
Routine Eye Exam |
$10 Copay |
One every 12 months |
Materials Copay |
$25 copay |
|
Frames (Retail Allowance) |
100% up to $125 |
Once every 24 months |
Lenses |
||
Single Vision |
100% |
Once every 12 months |
Bifocal |
100% |
Once every 12 months |
Trifocal |
100% |
Once every 12 months |
Standard Progressive |
$50 Copay |
Once every 12 months |
Contact Lenses |
||
Medically Necessary |
100% up to $250 |
Once every 12 months |
Elective |
100% up to $125 |
Once every 12 months |
Tier |
Per Pay Day Employee Cost |
|---|---|
Employee |
$2.29 |
Employee + Spouse |
$4.37 |
Family |
$6.78 |
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