•Medicare-covered glaucoma screening:  $0 copay 
•Medicare-covered eyewear (post-cataract):  $0 copay  
Routine vision:  
In-Network: 
VIS735 
•$0 copay for routine exam up to 1per year. 
•$200 maximum benefit coverage amount per year for contact  
lenses or eyeglasses-lenses and frames, fitting for eyeglasses-lenses  
and frames. 
•Eyeglass lens options may be available with the maximum benefit  
coverage amount up to 1pair per year. 
•Maximum benefit coverage amount is limited to one time use per