Avesis administers vision, hearing, and dental benefits to members of Guardian Healthcare in South Carolina.
Below you find an image of the ID card that members will present for services along with a description of the member's covered benefits.
Office Visit Co-Pay:$0.00 per office visit
Choose One per year (A or B):
| ADA Code | Description | Limitations |
| A |
D0120 |
Recall Exam |
One per year |
| B |
D0150 |
Comprehensive Exam |
One per year;limited to one every 3 years |
| ADA Code | Description | Limitations |
| A |
D1110 |
Cleaning |
One per year |
Office Visit Co-Pay:$0.00 per office visit
Choose One per year (A or B):
| ADA Code | Description | Limitations |
| A |
D0120 |
Recall Exam |
One per year |
| B |
D0150 |
Comprehensive Exam |
One per year; limited to one every 3 years |
| ADA Code | Description | Limitations |
| A |
D1110 |
Cleaning |
One per year |
| Benefits | Avesis Network | Frequency |
| Routine Hearing Test |
Covered in full after $30 co-pay |
One per year |
| Materials |
$300 max allowance for Hearing Aid |
Once every three years |
| Benefits | Avesis Network | Frequency |
| Routine Eye Examination |
Covered in full after $15 co-pay |
One per year |
| Materials |
$100 material allowance for Frames & Lenses OR Contact Lenses |
$100 allowance every two years |
| Benefits | Avesis Network | Frequency |
| Routine Eye Examination |
Covered in full after $10 co-pay |
One per year |
| Materials |
$200 material allowance for Frames & Lenses OR Contact Lenses |
$200 allowance every two years |
| Benefits | Avesis Network | Frequency |
| Routine Eye Examination |
Covered in full after $10 co-pay |
One per year |
| Materials |
$100 material allowance for Frames & Lenses OR Contact Lenses |
$200 allowance every two years |