We've got answers to your frequently asked questions.
How do I use my benefits?
Follow the clear path to your benefits! Just locate a provider, schedule an appointment and receive services. We'll handle all the paperwork, when you visit an in-network provider. You can also create an account at EyeMed.com or download our mobile app through the App Store or Google Play to view your benefits, find an eye doctor near you or check the status of your claims.
Can I view my EyeMed benefits online?
Yes, you can view your benefits and do a lot more on our secure website. You can also print an ID card, check the status of a claim, locate a provider and download an Explanation of Benefits. You can even download the EyeMed Members App through the App Store or Google Play to get access on the go.
How do I submit a claim?
When you visit one of our in-network providers we take care of all of the paperwork. If you see an out-of-network provider AND you have out-of-network benefits as part of your plan, you’ll need to pay at the time of service and complete a claim form to send to us for reimbursement. Please make sure you send in an itemized paid receipt with your name included.
Will I get an ID card? How do I order replacements or extra cards?
Yes, we provide 2 ID cards in the subscriber’s name, but you aren’t required to have it at the time of service. If you lose your card or need extras for your family, you can print a replacement by creating an account at EyeMed.com or download the EyeMed Members App through the App Store or Google Play to pull up a digital version anytime, anywhere.
How do I find a provider in your network?
EyeMed makes it easy to find an eye doctor and schedule an exam online. Visit our enhanced provider search to choose from nearly 82,000 in-network providers*. You can even filter your search by your frame preferences, provider hours and much more.
*On the access network
Does EyeMed offer any additional discounts?
We sure do! At participating in-network providers, members eyeing additional pairs receive 40% off a full pair or 20% off a partial pair (lenses only or frames only). You can also receive 20% off non-prescription sunglasses and accessories. If that’s not enough, you can create an account at EyeMed.com and login anytime to view additional special offers just for being an EyeMed member.
When I register, I am not able to see any of my dependents or not all of my dependents. Why?
Due to privacy guidelines, we only show family members who are under the age of 18 under the subscriber. Anyone 18 or older will need to register for his or her own account.
Does EyeMed sell individual plans?
EyeMed currently sells individual vision insurance plans in 42 states. Visit http://individual.eyemed.com to see if an individual plan is offered in your state. EyeMed Individual and Family plans start at just $5.00 per month.
Can I use my benefits online?
Can I apply FSA funds to out-of-pocket costs after my EyeMed benefit is applied?
Yes. You can use your Flexible Spending Account (FSA) to pay for a variety of health-related out-of pocket expenses, including those associated with supplementary benefits like an EyeMed plan. Money from the FSA can be applied toward the eye exam copay, out-of-pocket costs for prescription glasses or contact lenses (including upgrades) and supplies such as contact lens solution. Employees can even use FSA funds for LASIK surgery.
Vision care out-of-pocket costs are also eligible for Health Savings Account reimbursement, although these expenses do not count toward your annual deductible.
I don’t wear glasses and can see fine! Why do I need an eye exam?
Getting an eye exam is not just about finding out if you need glasses. It’s about your health! An eye exam can detect eye health problems like glaucoma or cataracts, but it can also help identify early signs of diseases that impact your whole body- high blood pressure, diabetes and high cholesterol – just to name a few. To learn more about vision wellness, visit www.eyesiteonwellness.com.
At what age should my child first visit the eye doctor?
The American Optometric Association recommends that your child should have his or her first eye exam with an optometrist or ophthalmologist between 6 months of age and 1 year. The doctor will check for nearsightedness, farsightedness, astigmatism, amblyopia (or "lazy eye"), proper eye movement and eye alignment, how the eye reacts to light and darkness, and other eye health problems.
They also recommend that your child's next eye exam should take place sometime between the ages of 3 and 5, and then every year after that. During these exams, the doctor will conduct a comprehensive eye exam as well as vision screening tests. To learn more about your child’s vision, visit www.eyesiteonwellness.com.
My child gets a vision screening at school, so there is no need for an eye exam, right?
A vision screening does not take the place of an eye exam. They generally check a child’s ability to see far away and check for color blindness, but a comprehensive eye exam will evaluate the entire structure of the eye and also allow the doctor to view nerves and blood vessels, providing a glimpse into a child’s overall health. Eye doctors will also check for farsightedness, which is more common in younger children.
How often should I get an eye exam?
As with any type of ongoing health care, annual eye exams are a good rule of thumb unless otherwise directed by your doctor. To learn more about eye exams, visit www.eyesiteonwellness.com.
Can I get the same quality of care at a retail provider as I can at an independent doctor?
Absolutely! In fact, many of the optometrists who practice in retail settings share space with an optical store but operate separately. All optometrists, regardless of the setting of their practice, must meet the same state licensing and credentialing requirements. In addition, due to the finite number of optometry schools in the United States, optometrists are trained consistently regardless of the practice model they eventually choose.
Where can I find a list of tiers for progressive lenses and anti-reflective coatings?
You can download a pdf copy of our tier classifications here.
Glossary of Vision Terms
Anti-Reflective Coating - A common lens coating that allows more light to pass through the lens, cutting down on glare and distracting reflections. This coating is good for night driving and is also cosmetically appealing because it allows others to see your eyes rather than the light reflection off the lenses.
Benefits - Specific dollar amounts reimbursed or specific discounts for each covered product or service.
Bifocal Lenses - Lenses prescribed for those who need correction for both far away and up close.
Claim - A request for payment of benefits.
Conventional Contact Lenses - Contact lenses designed for long-term use (up to one year); can be either daily or extended wear.
Copay - A specified dollar amount a member must pay out-of-pocket for a specified service at the time of service.
Dependent - A member’s spouse and/or child who meets the dependent criteria outlined by your employer/plan sponsor.
Disposable Contact Lenses - Contact lenses designed to be thrown away daily, weekly, bi-weekly, monthly or quarterly.
Eligible – qualified to receive benefits during a specified date range
High Index - A lighter, thinner lens material offered to those with very high prescriptions.
Lens Add-on/Option - Any option that does not come with the basic lens. This includes, but is not limited to, polycarbonate, scratch-resistant coating, tint and UV coating. May also be referred to as an “option” or “upgrade.” Add-ons listed on a plan are considered standard. Most add-ons also have premium options available.
Lenticular Lens - An infrequently-used technology needed in situations that require a high plus power that cannot be achieved with a traditional lens. This technology involves bonding one lens to the center of another to reach the correct power.
Medically Necessary Contact Lenses- Contact lenses are defined as medically necessary if the individual is diagnosed with one of the following specific conditions:
- Anisometropia of 3D in meridian powers
- High Ametropia exceeding –10D or +10D in meridian powers
- Keratoconus when the member’s vision is not correctable to 20/25 in either or both eyes using standard spectacle lenses.
- Vision improvement other than Keratoconus for members whose vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses
- All requests for medically necessary contact lenses must be submitted by network provider for review and approval by our Medical Director before a claim will be processed for the service.
Network (In-Network) - The doctors, clinics, health centers, medical group practices, facilities and other professional providers that a managed care organization has selected and contracted with to provide health care for its members. In the case of EyeMed, our network includes opticians, credentialed optometrists, and ophthalmologists who can provide services and/or prove glasses and contacts covered under the plan.
Out-of-Network (OON) Provider - A professional provider who is not in the network of approved/credentialed providers.
Patient Allowance - A fixed amount of dollars that may be applied toward the payment for a professional service and/or material as specified by the benefit.
Photochromic Lenses - Lenses that change color based on different levels of light. When the lenses are exposed to sunlight they darken; when exposed to lower light (indoors), they lighten.
Plastic (Basic Lens Material) - The most widely used lens material because it is lighter in weight than glass.
Polarized Lenses - A common lens add-on that cuts down on glare from the sun. Ideal for driving or outdoor activities, especially water and snow sports.
Polycarbonate - A commonly used lighter, thinner lens material that helps create a more impact-resistant lens.
Progressive Lenses - Multifocal lenses with no lines. Available in both standard and premium brands.
Provider - An optician, optometrist or ophthalmologist who is able to provide services or materials to someone with EyeMed benefits.
Scratch-Resistant Coating - A common lens coating that helps reduce scratches on the lenses.
Single Vision Lenses - Lenses prescribed for those who only need correction for one field of vision: either far away or up-close.
Tint - A common lens add-on that reduces the light that enters the eyes; can be doctor recommended or for fashion purposes.
Trifocal Lenses - Lenses prescribed for those who need correction for three fields of vision: far away, up-close and intermediate.
UV Coating - A common eyeglass lens coating that protects eyes from harmful ultraviolet light.