Vision Affinity Program
Vision Directory
The vision network for FEP BlueVision and the Affinity program is specific to routine vision care and is different from the network for your medical plan.
Prices represent maximum patient charges at network locations for the items listed. Prices and discounts are not available at Walmart locations. Walmart will apply a 10% discount on frames.
| Frames* | Member Pays | Average Discount |
|---|---|---|
| Priced up to $70 | $40 | 40% |
| Priced above $70 retail | $40 plus 10% off the amount over $70 | 28% |
| Lenses
(uncoated plastic)* | Member Pays | Average Discount |
|---|---|---|
| Single Vision | $35 | 30% |
| Conventional (lined) Bifocal | $55 | 27% |
| Conventional (lined) Trifocal | $65 | 28% |
| Lenticular | $110 | 31% |
| Lens Options
(Add to lens prices above)* | Member Pays | Average Discount |
|---|---|---|
| Standard Progressives** | $60 (private practices) / $75 (retailers) | 50%-70% |
| Premium Progressives** | $110 (private practices) / $125 (retailers) | 35%-60% |
| Glass Lenses | $18 | 40% |
| Polycarbonate Lenses | $30 | 50% |
| Scratch-Resistant Coating | $15 | 33%-66% |
| Anti-Reflective Coating | $45 | 20% |
| Ultraviolet (UV) Coating | $15 | 25% |
| Solid Tint | $10 | 30% |
| Gradient Tint | $12 | 20% |
| Photochromic Glass Lenses | $35 | 20%-45% |
| Plastic Photosensitive Lenses | $65 | 35%-55% |
| Polarized Lenses | $75 | 20% |
| Blended Segment Lenses | $20 | 60% |
| Intermediate Vision Lenses | $30 | 80% |
| High-Index Lenses | $55 | 40% |
| Eye Examinations | Member Pays | Average Discount |
|---|---|---|
| Routine Eye Examination | 15% off U & C or $5 off Retail Cost | 15% |
| Refraction Only (when examination is covered by Medicare) | $20 | 33% |
| Contact Lens Evaluation, Fitting and Follow Up | 15% off U & C or $10 off Retail Cost | 15% |
| Contact Lenses | Member Pays | Average Discount |
|---|---|---|
| Conventional | 20% off U & C | 20% |
| Disposable/Planned Replacement | 10% off U & C | 10% |
| Other Products | Member Pays | Average Discount |
|---|---|---|
| Non-Prescription Sunglasses | 20% off U & C | 20% |
| Other Ancillary Products/Solutions | 10% off U & C | 10% |
| Mail Order Contact Lens Replacement | For guaranteed lowest pricing. Call 1-800-536-7123 or visit
www.lens123.com | |
| Laser Vision Discount | Up to 25% off provider's U & C or 5% off any special offer*** | |
*Special lens designs, materials, powers and frames may require additional cost.
**Progressives copayment vary at private practices/retailers.
***Prior approval required. Call 1-800-551-3337.
Page last updated: November 30, 2012