Vision Plan

Vision Plan Overview

The EyeMed Select Vision Plan provides significant benefits and cost savings for routine eye exams, as well as a complete pair of eyeglasses (or contact lenses, instead of standard lenses).

You can receive care from an EyeMed in-network eye care professional or an out-of-network provider. If you choose an out-of-network provider, you will generally pay more and you will be responsible for paying the provider directly, as well as submitting a claim for reimbursement.

Learn More

EyeMed

866-299-1358

www.eyemed.com

Plan Documents

Vision Benefit Summary

Benefits may be subject to certain restrictions and limitations. Be sure to refer to the Plan Documents for a more complete description of plan benefits.

Benefits	EyeMed Select Vision Plan
Eye Exam In-Network Out-of-Network	$10 copay Up to $50 reimbursement
Frames/Lens
Single Vision In-Network Out-of-Network	$15 copay Up to $42 reimbursement
Bifocal Lenses In-Network Out-of-Network	$15 copay Up to $78 reimbursement
Trifocal Lenses In-Network Out-of-Network	$15 copay Up to $130 reimbursement
Frames/Lens	$130 allowance plus 20% off balance over $130 Up to $74 reimbursement
Contacts (in lieu of glasses)
In-Network Medically Necessary Elective	Covered in full $130 allowance plus 15% off balance over $130
Out-of-Network Medically Necessary Elective	$200 allowance Up to $104 reimbursement
Exam Frequency	12 months
Lens Frequency	12 months
Frames Frequency	24 months
Network Website www.eyemed.com	EyeMed Select

Vision Wellness

Set Your Sights on Healthy Vision

Visit Eyemed’s Eyesite on Wellness page for articles, videos, recipes and an expansive library of vision-related content.

Vision Symptom Checker

This tool can help you understand what your symptoms may mean and how to make the most out of your visit to the eye doctor.

Find a Provider

To find an EyeMed network provider or to request an out-of-network reimbursement claim form, log on to www.eyemed.com or call 866-299-1358.

Vision Plan Overview

Vision Plan

Learn More

Vision Benefit Summary

Vision Wellness

Find a Provider

Eligibility and enrollment

Health

Wellbeing

Financial Security

Resources

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