fep vision · 2021. 1. 11. · trifocal lenses up to $136 up to $136 lenticular lenses up to $136...
TRANSCRIPT
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Services/Materials We Pay (High Option) We Pay (Standard Option)
Exam Up to $60 Up to $60
Single Vision Lenses Up to $72 Up to $72
Bifocal Lenses Up to $109 Up to $109
Trifocal Lenses Up to $136 Up to $136
Lenticular Lenses Up to $136 Up to $136
Contact Lenses Up to $150 Up to $130
Medically Necessary Contact Lenses Up to $600 Up to $600
Frames Up to $200 Up to $140
bcbsfepvision.com
FEP VisionSM
INTERNATIONAL
2021 BLUE CROSS BLUE SHIELD FEP VISION INTERNATIONAL BENEFITS
Federal employees, retirees and their dependents who travel or live outside the United States and Puerto Rico can receive BCBS FEP Vision International benefits. See the 2021 BCBS FEP Vision brochure for benefit details.
WHY SHOULD YOU CONSIDER BCBS FEP VISION COVERAGE?
A comprehensive eye exam can detect a number of eye diseases, as well as signs of systemic conditions such as diabetes, thyroid disease, high blood pressure and neurological impairments.
2021 Summary of Benefits
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FIND A PROVIDER
Since we do not have in-network providers outside the United States and Puerto Rico, you may use the provider of your choice.
SUBMIT YOUR CLAIMS
Claim forms are available at bcbsfepvision.com. Completed claim forms and itemized bills should be sent to:
BCBS FEP Vision PO Box 2010 Latham, NY 12110-2010
Claims may also be faxed to (518) 220-6555 or email us at [email protected].
This is a summary of the many features and benefits of BCBS FEP VisionSM. For a complete description, please view the benefit brochure.
The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies.
The Blue Cross® and Blue Shield® words and symbols and BCBS FEP VisionSM are all trademarks owned by Blue Cross Blue Shield Association. BLUVISINT2021
2021 Premiums
PremiumsBI-WEEKLY MONTHLY
High Standard High Standard
Self Only $5.49 $3.50 $11.90 $7.58
Self + One $10.97 $6.99 $23.77 $15.15
Self & Family $16.46 $10.49 $35.66 $22.73
To enroll visit BENEFEDS.com or call 1-877-888-FEDS (3337), TTY: 1-877-889-5680. If calling from outside of the U.S., call 1-571-730-5942.
Open Season runs November 9 through midnight December 14, 2020, Eastern time.
Questions? Contact BCBS FEP Vision Customer Service:
If you're outside the U.S., call 1-518-220-6569 or visit us at bcbsfepvision.com.
Stay connected @bcbsfepvision