Western PA/Susquehanna Member Guide

25 To find a participating vision provider, log in to My Health OnLine and click Find Care. You can also call your Health Care Concierge team for assistance. E Vision benefits You receive a routine vision exam and allowance every one or two years (depending on your plan). • $0 copay for your routine vision exam. • Use your routine vision allowance 4 for the cost of eyewear, such as lenses and frames or contact lenses. Plan Routine vision allowance amount HMO Premier Rx (HMO) $150 per year HMO Deductible with Rx (HMO) $100 every two years HMO Rx Choice (HMO) $175 per year HMO Rx (HMO) $200 every two years HMO Rx Enhanced (HMO) $200 per year PPO High Deductible with Rx (PPO) $100 every two years PPO Rx Enhanced (PPO) $175 per year