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

$50 for frames.

$60 for single lenses.

$75 for bifocal lenses.

$95 for trifocal lenses.

$120 for lenticular lenses.

$200 for contact lenses.

Ductal lavage screening procedure for a member who is at high risk for breast cancer (limited to $1,000 for the member each calendar year).

Note: In-network benefits are provided when these covered services are furnished by a non-preferred radiologist or pathologist at a preferred hospital.

Endoscopic procedures that do not require anesthesia.