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Human Resources |
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Vision Coverage
Receiving your benefit is as easy as visiting any EyeMed provider. To locate providers, call 1(877)226-1115 to use EyeMed’s Provider locator service or speak with an EyeMed Customer Service Representative or you may also choose to log on to www.eyemedvisioncare.com and choose the provider locator option. A complete description of your benefit is detailed below.
| Vision Care Services | Co-Pay Member Cost |
Out-of-Network Allowance |
| Exam with Dilation as Necessary: | $20 Co-pay | Up to $35 |
| Exam Options: Standard Contact Lens Fit and Follow-up1 Premium contact Lens Fit and Follow-up2 |
Up to $55 10% off retail price |
N/A N/A |
| Frames: Any available frame at provider location |
$60 allowance, 20% off balance over $60 | $30 |
| Standard Plastic Lenses: Single Vision Bifocal Trifocal Lenticular Progressive |
$20 Co-pay $20 Co-pay $20 Co-pay $20 Co-pay $20 Co-pay |
Up to $25 Up to $40 Up to $55 Up to $55 Up to $55 |
| Lens Options: UV Coating Tint (Solid and Gradient) Standard Scratch-Resistance Standard Polycarbonate Standard Anti-Reflective Coating Other Add-Ons and Services |
$15 $15 $15 $40 $45 20% off retail price |
N/A N/A N/A N/A N/A N/A |
| Contact Lenses: (Contact lens allowance covers materials only.) a. Conventional b. Disposable c. Medically Necessary |
a. $0 Co-pay, $90 allowance, 15% off balance over $90 b. $0 Co-pay, $90 allowance, plus balance over $90 c. $0 Co-pay, Paid-in-full |
$72 $72 $200 |
| Frequency: Examination Frame Lenses or Contact Lenses |
Once every 12 Months Once every 12 Months Once every 12 Months |
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| LASIK and PRK Benefit: |
Members receive 15% off retail price or 5% off promotional price for LASIK or PRK from the U.S. Laser Network, owned and operated by LCA Vision. | |
| Continued Eyewear Savings: | Your EyeMed benefit also provides for continued savings on additional eyewear purchases. After your initial benefits have been utilized, you are able to receive ongoing discounts on additional complete pair eyewear purchases at EyeMed provider locations, which result in discounts up to 40% off the retail price. See your EyeMed provider for details. | |
 Contact Lens By Mail Program |
You may order replacement contact lenses for competitive prices via the internet, and have the contacts mailed directly to your home. The service is for replacement contact lenses only, and your core benefit allowance or discount will not apply to the service. Your initial pair of contact lenses must still be purchased from your eye care provider to ensure proper fit and follow-up care. Simply visit www.eyemedvisioncare.com for details, and a link to the order site. | |
- Standard Contact Lens Fitting – spherical clear contact lenses in conventional wear and planned replacement (Examples include but not limited to disposable, frequent replacement, etc.)
- Premium contact Les Fitting – all lens designs, materials and specialty fittings other than Standard Contact Lenses (Examples include toric, multifocal, etc.)
Plan Limitations/Exclusions:
- Orthoptic or vision training, subnormal vision aids, and any associated supplemental testing
- Aniseikonic lenses
- Medical and/or surgical treatment of the eye, eyes, or supportung structures
- Services provided as a result of any Worker’s Compensation law
- Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan
- Plano non-prescription lenses and non-prescription sunglasses (except for 20% discount)
- Services or materials provided by any other group benefit providing for vision care
- Benefit is not available on those frames where the manufactuer prohibits a discount
- Standard Progressives are not available at all Provider locations.
Page last updated: April 10, 2006.