ENGLISH Resources Guardian Group Number: 00654321 Guardian Customer Service 1-800-627-4200 Downloads Guardian Enrollment Kit 2018 |
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Vision Benefits Summary
Provided by the
Guardian Life Insurance Company of
America
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Network
Copay |
Davis Vision
Exam: $10 Copay
Materials: $25 Copay
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Exams |
Every 12 months |
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Lenses (Glasses or contacts) |
One pair every 12 months
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Frames |
One set every 24 months
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Eye Exams
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In-Network: Covered at 100% after copay
Out-of-Network: Covered up to $50 |
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Single Vision Lenses |
In-Network: Covered at 100% after copay
Out-of-Network: Covered up to $48 |
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Lined Bifocal Lenses
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In-Network: Covered at 100% after copay
Out-of-Network: Covered up to $67
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Lined Trifocal Lenses |
In-Network: Covered at 100% after copay
Out of Network: Covered up to $86 |
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Lenticular Lenses |
In-Network: Covered at 100% after copay
Out-of-Network: Covered up to $126 |
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Frames |
In-Network: 80% of amount over $150
Out-of-Network: Covered up to $48
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Contact Lenses |
See attached benefits plan for details |
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* This is only a partial list of vision services. See attached Guardian Benefits Plan for complete descriptions of Full Feature and Discount Access plans offered. |
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