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Johns Hopkins University Retirees Plan — 2021-2022

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EHP Network ProviderOut of Network Provider
Contact Lenses
Medically necessaryNot CoveredNot Covered
ElectiveNot CoveredNot Covered
Materials
Single visionNot CoveredNot Covered
BifocalNot CoveredNot Covered
TrifocalNot CoveredNot Covered
LenticularNot CoveredNot Covered
FramesNot CoveredNot Covered
Vision Exam
Vision Exam100% of allowed amount; deductible waived (one exam every two years; excludes contact lens fitting fee)Not Covered
Revised
September 13, 2022
Group Number
E00051 (*003/*004)
Plan Codes
225
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