Preferred Eyecare Providers, Inc.: Value Plan D

Preferred Eyecare Providers VisIcare® Value Plan D is a discount program rather than an insurance plan. There are no claim forms to be filled out, and there is no reimbursement. Your benefit is the substantial savings that have been specially negotiated for you. You pay the PEP doctor only the discounted fees according to the Fee Schedule. All you need to do is call and make an appointment with the PEP doctor of your choice, present your membership card at the time of your appointment and professional services and eyewear will be furnished at the substantially reduced fees. Your one time annual fee of $19.00 entitles you and your family to use the plan as often as you need or want to.

Preferred Eyecare VisIcare ® Value Plan (D) Fee Schedule Comprehensive Eye Examination by Ophthalmologist or Optometrist (including dilation as indicated). Patient pays 85% of Usual and Customary Fee up to $53.00.*
Glass or Plastic (CR-39) Lenses**:
Single Vision	$ 39.00
Bifocals (FT 25 or 28)	$ 69.00
Trifocals (FT 25 or 28)	$ 94.00
Progressive Bifocals (Standard)	$ 119.00
(Varilux and other special progressives 20% off UCR)
Options:
Polycarbonate - (SingleVision) - add	$ 19.00
Solid Tints - add	$ 8.00
Gradient Tints - add	$ 12.00
Scratch Coatings - add	$ 11.00
U.V. Coatings - add	$ 12.00
All Other Options - 20% off UCR
Frames
All available frames	25% off Usual & Customary Fee
(After Discount not less than 2.1 x Frame Facts Cost)
Contact Lenses:
Conventional soft & gas permeable lens	20% off UCR
Toric and Bifocal Lenses	15% off UCR
Disposable & Frequent Replacement Lenses	7% off UCR
Contact Lens Fitting & Follow up	15% off UCR
NOTES:
* Add $12.50 for contact lens examination
** Power greater than + or - 6.00 is 20% off UCR

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