monitor Medical Conditions, as often as Medically care provider office visits Necessary. Enrollees age 19 and over: No charge; Enrollee pays nothing limited to an Eyeglass frames, lenses (any type), lens options such as Allowance of $150 every 24 months tinting, or prescription contact lenses, contact lens evaluations and examinations associated with their fitting. The benefit After Allowance, Enrollee pays 100% of all charges period begins on the date services are first obtained. The Allowance may be used toward the following in any Contact Lenses or Framed Lenses for Eye combination: Pathology: After Deductible, Enrollee pays 15% • Eyeglass frames Plan Coinsurance • Eyeglass lenses (any type) including tinting and coating • Corrective industrial (safety) lenses • Sunglass lenses and frames when prescribed by an eye care provider for eye protection or light sensitivity • Corrective contact lenses in the absence of eye pathology, including associated fitting and evaluation examinations • Replacement frames, for any reason, including loss or breakage • Replacement contact lenses • Replacement eyeglass lenses Contact lenses or framed lenses for eye pathology when Medically Necessary. One contact lens per diseased eye in lieu of an intraocular lens is covered following cataract surgery provided the Enrollee has been continuously covered by KFHPWA since such surgery. In the event an Enrollee’s age or medical condition prevents the Enrollee from having an intraocular lens or contact lens, framed lenses are available. Replacement of lenses for eye pathology, including following cataract surgery, is covered only once within a 12-month period and only when needed due to a change in the Enrollee’s prescription. Enrollees to age 19: Frames and Lenses (in lieu of contact lenses): No Eyeglass frames, lenses (any type), lens options such as charge; Enrollee pays nothing for 1 set of frames and tinting, or prescription contact lenses, contact lens evaluations lenses per calendar year and examinations associated with their fitting. The benefit period begins on January 1 and continues through the end of Contact lenses (in lieu of eyeglasses): Enrollee the calendar year. The benefit may be used toward contact pays 50% coinsurance lenses (in lieu of eyeglasses) or 1 eyeglass frame and pair of lenses. After benefit is exhausted: Not covered; Enrollee • Eyeglass frames pays 100% of all charges • Eyeglass lenses (any type) including tinting and coating Contact Lenses or Framed Lenses for Eye • Corrective industrial (safety) lenses Pathology: After Deductible, Enrollee pays 15% • Corrective contact lenses in the absence of eye Plan Coinsurance PEBB_SCA_2024 35