Vision

 

(Optional)

Administered by Eye Med Vision Care, 1-866-723-0596 (prior to enrolling), 1-866-723-0513 (after enrolling).
www.eyemedvisioncare.com (after enrolling)

EyeMed Claim Form


Vision Eligiblity

Employees, spouses, adult dependents, retirees,
and children are eligible if you elect to have this coverage.


Locating Your Doctor

Quality vision care is important to your eye wellness and overall health care. Accessing your EyeMed Vision Care benefit is easy. Simply locate a participating provider, schedule an appointment, present your ID card at the time of service, and the provider will take care of the rest.

Check the online provider locator at www.eyemedvisioncare.com, choose the ACCESS network for a provider near your zip code.Once enrolled, visit: www.eyemedvisioncare.com, register by entering your email address and choosing a password to view coverage and eligibility status.


Value Added Discounts

Members will receive a 20% discount on items not covered by the plan at Network Providers. Members also receive 15% off retail price or 5% off promotional price for Lasik or PRK from the US Laser Network. Members receive a 40% discount off complete pair of eyeglasses purchased and an additional 15% discount off conventional contact lenses once the funded benefit has been used.

 

Out-of-Network Providers

  1. Once enrolled, registered members can access their out-of-network benefit by:
  2. Downloading an Out-of-Network Claim Form from the EyeMed Vision Care website, www.eyemedvisioncare.com, or by calling the Customer Care Center.
  3. Make an appointment with an out-of-network provider you trust as your choice for vision care provider.
  4. Pay for all services at the point of care and receive an itemized receipt from the provider office.
  5. Complete the out-of-network claim form and submit along with receipts to EyeMed Vision Care’s claims department for direct reimbursement.

 

Rates

Monthly Vison Rates:
Employee Only $7.11
Employee & Spouse/Adult Dep. $13.42
Employee & Child(ren) $14.13
Employee & Family $20.73

 

Service/Material

Coverage from an
EyeMed Doctor

Out-of-Network
Reimbursement

Rural OON
Reimbursement**


Exam with dilation as necessary:

Once every benefit year
$10 copay
Up to $45
Up to $85
Frames:
Once every two years
$125 allowance,
20% off balance over $125
Up to $52
Up to $100
Single Vision
Bifocal
Trifocal
Standard Progressives
Once every benefit year in lieu of contacts
$20 copay
$20 copay
$20 copay
$85 copay
Up to $45
Up to $55
Up to $65
Up to $55
Up to $45
Up to $55
Up to $65
Up to $55
Contact Lens Materials:
Conventional & Disposable

*Medically Necessary
Once every benefit year in lieu of eyeglass lenses

$125 allowance

$125 allowance paid in full

Up to $95

Up to $200

Up to $100

Up to $200

Contact Lens Exam Fees:
Standard Contact Lens Fit & Follow-up

Premium Contact Lens Fit & Follow-up
Once every benefit year

$20 copay, paid in full fit and
two follow up visits

$20 copay, 10% off retail price, then apply $35 allowance

Up to $40

Up to $40

Up to $40

Up to $40

Lens Options:
UV Coating
Tin (Solid and Gradient)
Standard Scratch Resistance
Standard Polycarbonate
Standard A/R

$15 copay
$15 copay
$15 copay
$40 copay
$45 copay
NA
NA

* Contact lenses that are required to treat medical or abnormal visual conditions, including but not limited to eye surgery (i.e. cataract removal), visual perception in the better eye that cannot be corrected to 20/70 through the use of eyeglasses, and certain corneal or other eye diseases.

**To qualify for the enhanced rural out-of-network benefit, employees must meet the definition of rural employee, meaning any MUS employee and dependents enrolled on the vision plan who reside more than 50 miles from the nearest network provider.



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