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Explore options available at no extra cost to you.

Plan Details1 Option A Option B
Benefit Year Maximum - Plan Pays $1,500 $2,000
Benefit year Deductible2
Single $25 $25
Family $75 $75
Preventive & Diagnostic - member pays 20% 0%
Basic Restorative

Including cavity repair, tooth extractions, restoration of decayed or fractured teeth, oral surgery and anesthesia

50% 20%
Major Restorative

Including root canals, gum and bone disease, crowns, inlays, bridges and dentures

50% 50%
Add Orthodontia
Orthodontics 50% 50%
Orthodontic lifetime maximum

(per child, up to age 19)

$1,000 $2,000
1 Benefits and general provisions described are subject to plan selected, and terms of the actual policy and coverage manual.
2 Deductible waived for preventive and diagnostic services.

Plan Details2 Avēsis 80 Avēsis 150
Eye Exam Covered in full after $10 copay, every 12 months Covered in full after $10 copay, every 12 months
Eyewear products
Frames Covered once every 24 months, after $25 materials copay; $80 retail allowance Covered once every 24 months, after $10 materials copay; $150 retail allowance
Standard plastic lenses One pair covered in full after materials copay, every 12 months One pair covered in full after materials copay for adult polycaronate, scratch-resistant coating, UV screening, standard tint, anti-reflective coating, every 12 months
Contact lenses Covered up to allowance, every 12 months, in lieu of eyeglasses Covered up to allowance, every 12 months, in lieu of eyeglasses
Lens Options Up to 20 percent off polycarbonate, scratch-resistant coating, tint and UV protective coating
  • Covered in full: polycarbonate, scratch-resistant coating, tint and UV protective coating
  • Copay applies: progressives, transitions, polarized, PGX/PBX
  • Up to 20% discount: other lens options
BONUS: Free hearing screening and reduced pricing on hearing devices through Amplifon Hearing Health CareTM3
Avēsis Vision is an independent vision insurance company that does not provide Blue Cross and Blue Shield products and services. Avēsis Vision is underwritten by Fidelity Life Insurance Company.
Hearing Discount Savings Plan provided by Amplifon Hearing Health Care. Amplifon Hearing Health Care is an independent company that does not provide Wellmark Blue Cross and Blue Shield products or services.
3 Applies to in-network benefits. Out-of-network services are covered and include higher copays. Coverage is available for members age 19 or older.