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These benefits also include medical supplies (such as sterile packs, dressings, syringes, needles, clamps and gauze) required for the treatment of cancer of the colon, liver, pancreas, liver and bile ducts.

Dental prosthetics (including dentures, bridges, braces and other dental appliances) that are required due to accidental injury when accident occurs after effective date.

This health plan also covers medically necessary inpatient admissions in a participating nursing home. These admissions are subject to the same provisions that apply for admissions in a skilled nursing facility, except that benefits for room and board charges are limited to a maximum payment of $20 for each day.

$25 for frames in the premier or designer or fashion selection.

$0 for single vision, bifocal and trifocal lenses, glass grey #3 lenses, overdiopter, lenticular and fashion, sun or gradient tinted plastic lenses, blended invisible bifocals, progressive addition multifocals, PGX glass single vision or multifocal lenses and UV coating and polycarbonate lenses for children.

In addition, this health plan covers one set of prescription lenses (or contact lenses instead) for each member every 12 months and/or frames every 24 months. For covered vision supplies, the member pays:

$25 for single lenses.

$40 for bifocal lenses.

$80 for lenticular lenses.

$105 for contact lenses.