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Vision Claim Form

As part of the preventive care services under your Dartmouth College medical plan, coverage includes the following:



In addition, you can also take advantage of vision discounts through:

Summary of Benefits


* Your Frequency Period begins on January 1 (calendar-year basis).

** Declining balance can be applied toward any covered materials (frames, lenses, and contact lenses) and drawn against throughout the stated frequency period.

*** Healthy Rewards is a discount program. Some Healthy Rewards programs are not available in all states and programs may be discontinued at any time. If your Cigna plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. Healthy Rewards programs are separate from your plan benefits. A discount program is NOT insurance, and you must pay the entire discounted charge.

Last Updated: 7/24/18