The Anthem vision plan provides a benefit for an eye exam, eyeglass frames, and contact lenses or eyeglass lenses.  If you visit an in-network provider, you pay a copay for your standard eye exam, and the plan pays a benefit of up to $250 for frames and contact lenses.  There are additional copays and costs that could apply for a contact lens exam and eyeglass lens options.  With the Anthem vision plan, you may visit any vision provider.  However in order to maximize your vision benefit, we encourage you to visit an in-network provider. 


Important Documents

Frequency limitations: The exam benefit, lenses benefit, and frames benefit are all once per calendar year. Either the eyeglass benefit or the contact benefit may be used in the same benefit period.

Participating vision provider information can be found on the Resources page.

Vision Summary of Benefits In-Network
Eye Exam
Standard $20 copay
Eyeglass Lenses
Single $20 copay
Bifocal $20 copay
Trifocal $20 copay
Lenticular $20 copay
Lens Options
Transitions (children to age 19) $0 copay
Standard Polycarbonate (children to age 19) $0 copay
Factory Scratch Coating $0 copay
Standard Progressive $65 copay
UV Coating $15 copay
Standard Polycarbonate (Adults) $40 copay
Eyeglass Frames
Plan pays $250 less $20 copay, then 20% off balance Additional pairs: 40% discount
Contact Lenses
Conventional & Disposable $250 allowance, then 15% off balance
Medically necessary (see definition below) Covered in full


  • Exam: Once per calendar year
  • Lenses: One pair per calendar year
  • Frames: One pair per calendar year


The plan covers either contact lenses OR eyeglass lenses once per calendar year.

Medically Necessary Definition and Process

The definition of medical necessity for vision coverage is as follows:

  • Non-elective (medically necessary) contact lenses are prescribed by a doctor solely for purposes of correcting a specific medical condition that prevents your vision from being corrected to a specified level of visual acuity using conventional eyeglasses. Choosing contacts over glasses for a standard prescription is considered elective/cosmetic.
  • Medically Necessary: Contact lenses that are applied to meet the requirements related to eye conditions. These eye conditions prevent the member from achieving a specified level of visual acuity with conventional spectacle lenses; the contact lenses may be any modality (soft conventional, soft disposable gas permeable, etc.) depending on the eye condition and the recommendation of the provider.

The provider provides an examination, and if the member has qualifying conditions that determine the member to be qualified for medically necessary contacts by the provider, then the in-network provider submits a preauthorization. The preauthorization process is not a pre-approval process; it is an eligibility review.  The preauthorization will be screened and sent to the National Optometric Director for approval.  Upon approval the provider will need to submit both the claim, preauthorization, and approval for processing.

Employment Termination of Coverage

Your vision insurance coverage will conclude on the last day of the month in which your employment termination takes place. 

Your vision coverage is a COBRA eligible benefit. Under COBRA regulations, you have the opportunity to extend your vision benefits for up to a maximum of 18 months from the date your coverage ends. This enables you to maintain access to the same vision benefits you enjoyed as an active Jim Ellis employee. 

Following your employment's conclusion with Jim Ellis, you will receive a comprehensive COBRA continuation notice with details on how to continue your vision coverage through COBRA.