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Vision Benefits at a Glance
AmeriHealth Forms Online — New Jersey
Forms are in PDF format.
Plan
Option
HMO/POS
$35 Bi-Annual Corrective Eyeware Benefits
HMO/POS
$100 Bi-Annual Corrective Eyeware Benefits
Freestanding
$35 Annual Corrective Eyewear Benefits
Freestanding
$35 Bi-Annual Corrective Eyeware Benefits
Freestanding
$100 Annual Corrective Eyeware Benefits
Freestanding
$100 Bi-Annual Corrective Eyewear Benefits
Freestanding
$200 Annual Corrective Eyeware Benefits
Freestanding
$200 Bi- Annual Corrective Eyeware Benefits
Freestanding
$250 Annual Corrective Eyewear Benefits
Freestanding
$250 Bi-Annual Corrective Eyeware Benefits
EPO
$35 Every Year
EPO
$35 Every Two Years
EPO
$35 Routine Eye 12 Months and Materials every 24 Months
EPO
$100 Every Year
EPO
$100 Every Two Years
EPO
$100 Routine Eye 12 Months and Materials every 24 Months