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WBMA MEDICAL INSURANCE
Vision Benefits Vision benefits are for once every 24 months and includes a $10. exam co-payment and $25. hardware co-payment. This is also a PPO Plan Participants will receive the best benefits if they choose to use a preferred VSP provider. For a list of providers in your area you can call WBMA at 1-888-551-9262.
| Benefits for VSP Participating Providers |
| Examination |
$10 copay |
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| Lenses (Pair) |
$25. copay |
Single Vision |
Paid in Full |
Bifocal |
Paid in Full |
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Trifocal |
Paid in Full |
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| Contact Lenses (pair) |
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Necessary |
Paid in Full |
Cosmetic |
Up to $200. |
| Benefits for Other Licensed Vision Providers |
| Examination |
up to $45.00 |
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| Lenses (Pair) |
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Single Vision |
up to $42.00 |
Bifocal |
up to $72.00 |
Trifocal |
up to $82.00 |
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| Contact Lenses (pair) |
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Necessary |
up to $210. |
Cosmetic |
Up to $125. |
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