VISION
EyeMed Vision Care

866-939-3633

Group #: 9679085

Full-time employees who actively work at least 30 hours per week are eligible for vision benefits, along with their legal spouse, dependent children up to age 26, and children of any age if they depend on the employee for support due to a disability. Coverage for new hires begins on the first of the month following their date of hire. Go back to Employee Benefits

Providers

To use the EyeMed Provider Locator service, click here to search the website or call 866-939-3633 to speak with a customer service representative. No insurance card is needed. Providers will verify your participation through EyeMed

In-network options include:

  • Private optometrists, ophthalmologists, opticians, and optical retailers such as LensCrafters, JC Penney Optical, Target Optical, and most Pearle Vision and Sears Optical locations
  • Online through glasses.com and contactsdirect.com

Employee Premiums

Single (Per Pay Period)

Single (Per Pay Period)

$1.00

Two-Party (Per Pay Period)

Two-Party (Per Pay Period)

$2.00

Family (Per Pay Period)

Family (Per Pay Period)

$3.00

Plan Information

Allowances are one-time use benefits; no remaining balance. Lost or broken materials are not covered.

Payment Schedule:

Vision Care Services

Member Cost In-Network

Out-of-Network Reimbursement

Vision Care Services

Exam with dilation as necessary

Member Cost In-Network: $10 copay

Out-of-Network Reimbursement: Up to $35

Contact lens fitting and follow-up (Available after a comprehensive eye exam is conducted)

Standard*

Member Cost In-Network: Up to $55

Out-of-Network Reimbursement: N/A

Premium**

Member Cost In-Network: 10% off retail price

Out-of-Network Reimbursement: N/A

Frames

Member Cost In-Network: $100 allowance; 20% off balance over $100

Out-of-Network Reimbursement: $50.00

Standard plastic lenses

Single vision

Member Cost In-Network: $10 copay

Out-of-Network Reimbursement: Up to $25

Bifocal

Member Cost In-Network: $10 copay

Out-of-Network Reimbursement: Up to $40

Trifocal

Member Cost In-Network: $10 copay

Out-of-Network Reimbursement: Up to $55

Standard progressive lens

Member Cost In-Network: $75

Out-of-Network Reimbursement: Up to $40

Premium progressive lens

Member Cost In-Network: $75, 80% of charge less $120 allowance

Out-of-Network Reimbursement: Up to $40

Lens options (paid by the member and added to the base price of the lenses)

Tint (solid and gradient)

Member Cost In-Network: $15

Out-of-Network Reimbursement: N/A

UV coating

Member Cost In-Network: $15

Out-of-Network Reimbursement: N/A

Standard plastic scratch coating

Member Cost In-Network: $15

Out-of-Network Reimbursement: N/A

Standard polycarbonate

Member Cost In-Network: $40

Out-of-Network Reimbursement: N/A

Standard antireflective

Member Cost In-Network: $45

Out-of-Network Reimbursement: N/A

Other add-ons and services

Member Cost In-Network: 20% discount

Out-of-Network Reimbursement: N/A

Contact lenses (allowance covers materials only)

Conventional

Member Cost In-Network: $115 allowance; 15% off balance over $115

Out-of-Network Reimbursement: Up to $92

Disposables

Member Cost In-Network: $115 allowance; plus balance over $115

Out-of-Network Reimbursement: Up to $92

Medically necessary

Member Cost In-Network: $0 copay, paid in full

Out-of-Network Reimbursement: Up to $200

LASIK and PRK vision correction procedures

Member Cost In-Network: 15% off retail price OR 5% off promotional pricing

Out-of-Network Reimbursement: N/A

Frequency

Exams

Member Cost In-Network: Once every 12 months

Out-of-Network Reimbursement:

Frames

Member Cost In-Network: Once every 24 months

Out-of-Network Reimbursement:

Standard plastic lenses

Member Cost In-Network: Once every 12 months

Out-of-Network Reimbursement:

Contact lenses (in lieu of standard plastic lenses)

Member Cost In-Network: Once every 12 months

Out-of-Network Reimbursement:

*Standard contact lens fitting—spherical clear contact lenses in conventional wear and planned replacement (examples include but are not limited to disposable, frequent replacement, etc.)

**Premium contact lens fitting—all lens designs, materials, and specialty fittings other than standard contact lenses (toric, multifocal, etc.)

Resources

EyeMed Vision Care Benefits Summary
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