$150 Reimbursement Limit for Covered Services received in the 2025 Benefit Period. Coverage is limited to the services performed/ prescribed by a physician.
Vision Claim Form
Original detailed invoices and sales receipts are required and must be submitted with a Vision Services Claim form. See the claim form
All 2025 claims must be submitted to your Insurance Group Representative by March 31, 2026, in order to qualify for the 2025 reimbursement limit. Any unused portion of the 2025 reimbursement is available for use in the 2026 benefit period for services received in 2026. See the Plan Document for additional information.