Frequencies are for either eyeglasses or contacts. 

Benefit per covered individual	Frequency for eyeglasses or contacts
Eyeglass lenses	once per calendar year
Frames	once per calendar year
Contacts in lieu of eyeglasses	once per calendar year

For information about Lasik frequencies visit the Blue Cross Vision page.

Benefits are provided for eyeglasses including frames and lenses or contact lenses once per calendar year per covered individual when you see an in-network provider.

Frames

• $0 copay for Davis Vision Exclusive Collection frames
• In-network with participating retailers - $150 allowance toward any frame
• VisionWorks stores - $200 allowance toward any frame

Your MDEA dollars can be used for most expenses including copays.

Benefits for contact lenses once per calendar year per covered individual.

Benefit	Copay
Evaluation, fitting, and follow-up care for standard lenses	$10
Evaluation, fitting, and follow-up care for specialty lenses	$10 copay, up to $60 allowance
Included Collection contact lenses up to 8 boxes - Disposable	$0
Included Collection contact lenses up to 4 boxes - Non-disposable	$0
Non-collection contact lenses	up to $150 allowance

Your MDEA dollars can be used for most expenses including copays.

• No cost consultation at network providers
• Up to 40 - 50% off the national average at network providers
• For more information

Your MDEA dollars can be used for most expenses including copays.

The Blue Cross Vision plan uses the Davis Vision network of retailers and independent provider offices. Use the Vision plan provider finder to find a participating retailer near you.

Opportunities for enrollment include:

• When you are hired or transition into an insurance eligible position.
• When you experience a Qualified Life Event (see Change My Coverage).
• During the annual Open Enrollment period.
  

Things to note:

• You do not need to be enrolled in the Minnesota Advantage Health Plan to enroll in the Blue Cross Vision plan.
• You may enroll regardless of choosing either Blue Cross and Blue Shield of Minnesota or HealthPartners as your Minnesota Advantage Health Plan administrator.
• You can enroll in this plan even if you've waived Minnesota Advantage Health Plan coverage.

Premiums are paid through payroll on a pre-tax basis.

Coverage level	Cost per month	Cost semi-monthly
Single	$4.18	$2.09
Family	$11.98	$5.99

For more information see the Blue Cross Vision plan State of Minnesota employee landing page.

Blue Cross Vision Member Services: 1-888-921-1192

Vision Plan Summary

Summary of Material Modification (SMM) - A summary of changes to the Summary of Benefits effective July 1, 2025.

For information about MDEA qualified expenses visit Benefit Resource (BRI)