2020 BLUE CROSSAND BLUE SHIELD

VISIONCOVERAGEVision coverage for retireduniformed service members,their families and dependentsof active duty service members.

fepbluevision.com • 1-888-550-BLUE (2583)

High Option Standard Option

MONTHLY MONTHLY

Self Only $11.90 $7.58

Self + One $23.77 $15.15

Self & Family $35.66 $22.73

2020 RATES

BLUVISUS2020

Note: This is a summary of the many features and benefi ts of FEP BlueVision®. For a complete description, please refer to your benefi t brochure.

This is a summary of the many features and benefi ts of FEP BlueVision. For a complete description, please view the benefi t brochure.

The Blue Cross® and Blue Shield® words and symbols and FEP BlueVision® are all trademarks owned by Blue Cross Blue Shield Association.

FEP BlueVision complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Para obtener asistencia en español, llame al servicio de atención al cliente al número que aparece en su tarjeta de identifi cación.

Open Season is November 11 through midnight December 9, 2019, Eastern time.

Learn more about FEP BlueVision

Online: fepbluevision.com

Phone: 1-888-550-2583 (8 a.m. to 11 p.m. EST, M-F;9 a.m. to 4 p.m. EST, Sat.;12 p.m. to 4 p.m. EST, Sun.)

Enroll in coverage

Online: BENEFEDS.com

Phone: 1-877-888-3337(Available 24/7)

GET THE MOST OUT OF YOUR VISION BENEFIT

On our website, fepbluevision.com, you can accessa wealth of resources including, but not limited to:

Virtual Frame Try-On

Vision Provider Finder

Information on vision health

Full coverage details

Who is eligible for coverage*

• Retired uniformed service members and their families

• Family members of active duty service members

• Retired Reserve members and their families

Learn more about eligibilityat BENEFEDS.com*You must be enrolled in a TRICARE health plan to also enroll in FEP BlueVision.

HERE’S WHY MORE FEDERAL EMPLOYEES CHOOSE BLUE:

No copays for comprehensive eye exams, frames and lenses

Our insurance is accepted by over 91,000 providers, including Visionworks, LensCrafters, Costco, Walmart, Sam’s Club and more

An extensive fully covered frame collection at participating providers

A generous frame allowance at independent and national providers

Through our exclusive partnership with Visionworks, High Option members receive up to a $200 frame allowance on new frames

Benefits High Option Standard Option

Eye Exam (Once per year)

No copay, covered every calendar year.

Spectacle Lenses (One pair per year)

No copay, covered every calendar year.

Lens TreatmentsWe cover Transitions, Varilux Progressives and Crizal Anti-Reflective Coating lenses at low or no out-of-pocket cost. See additional covered lens options in the 2020 brochure.

Frames

No copay, covered every calendar year.

Frame Allowance: $150 toward any provider supplied frame, plus 20% off charges over $150.2

Additional $50 frame allowance when you purchase frames from Visionworks.

No copay, covered every 2 calendar years.

Frame Allowance: $130 toward any provider-supplied frame, plus 20% off charges over $130.2

FEP BlueVision Exclusive Collection1

Covered-in-full and includes any frame from the FEP BlueVision Exclusive Collection.1

Contact Lenses (in lieu of eyeglasses)

Up to $150 per calendar year toward contact lenses plus 15% off charges over $150.2 Evaluation, fitting and follow-up fees fully covered for non-specialty lenses and covered up to $60 for specialty contact lenses.

Up to $130 per calendar year toward contact lenses, evaluation, fitting and follow-up fees, plus 15% off charges over $130.2

2020 Summary of Benefits

Blue Cross and Blue Shield is a trusted provider of health insurance for federal employees, retirees and their families. Our supplemental vision plan, FEP BlueVision®, offers the coverage you need to keep eyes healthy for years to come.

1Collection is available at participating independent provider offices. Collection is subject to change.2Additional discounts are not applicable at Costco, LensCrafters, Sam’s Club or Walmart locations.

Did you know

People with eye conditions are more likely to suffer more serious health conditions, such as diabetes or autoimmune disease. Taking steps to protect you and your family’s eyes is important today.

MORE GREAT DISCOUNTS FOR FEP BLUEVISION MEMBERS

Vision Correction Surgery: Save up to 50% on traditional LASIK surgery at QualSight LASIK.

Additional eyewear savings: 20% discount on additional frames, spectacle lenses or daily wear contacts and 10% discount when you buy additional disposable contacts.

Blue365®: Get savings on things that go beyond vision coverage, such as gym memberships and nutrition programs.

Hearing health: Save up to 40% on discreet hearing aids with the latest technology.

Learn more at fepbluevision.com.

Average Retail Cost High Option

Average savings with High Option:

$865

Standard Option

$988 $123 $219

$103

$150

$30

$125

$40

$20

$120

$125

$275

$0

$0

$0

$0

$0

$0

$0

$33

$90

$0

$16

$0

$0

$0

$0

$65

$48

$90

Eye Examination

Frames

1-Year Breakage Warranty

Polycarbonate Lenses

Bifocal Lenses

Ultraviolet Coating

Premium Anti-Reflective Coating

Premium Progressive Lenses

TOTAL OUT-OF-POCKET

Plastic Photochromic Lenses (i.e., Transitions® SignatureTM)

Average savings with Standard Option:

$769

Savings you can clearly see