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Vision

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.

866-939-3633  |  eyemed.com/en-us  |  Group #: 9679085

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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 a network of independent eye doctors as well as retail and online providers including, LensCrafters, Target Optical, glasses.com, and contactsdirect.com.

Employee Premiums
Single (Per Pay Period)
$1.50
Two-Party (Per Pay Period)
$3.00
Family (Per Pay Period)
$4.50

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
Exam with dilation as necessary
$10 copay
Up to $35
CONTACT LENS FITTING AND FOLLOW-UP (Available after a comprehensive eye exam is conducted)
Standard*
Up to $55
N/A
Premium**
10% off retail price
N/A
FRAMES
Frames
$150 allowance; 20% off balance over $150
$50.00
STANDARD PLASTIC LENSES
Single Vision
$10 copay
Up to $25
Bifocal
$10 copay
Up to $40
Trifocal
$10 copay
Up to $55
Standard progressive lens
$75 copay
Up to $40
Premium progressive lens
$75 copay, 80% of charge less $120 allowance
Up to $40
LENS OPTIONS (paid by the member and added to the base price of the lenses)
Tint (solid and gradient)
$15
N/A
UV Treatment
$15
N/A
Standard plastic scratch coating
$15
N/A
Standard Polycarbonate
$40
N/A
Standard antireflective coating
$45
N/A
Other add-ons and services
20% off retail price
N/A
CONTACT LENSES (allowance covers materials only)
Conventional
$150 allowance; %15 off balance over $150
Up to $92
Disposables
$150 allowance; plus balance over $150
Up to $92
Medically necessary
$0 copay, paid in full
Up to $210
OTHER
Lasik and PRK Vision Correction Procedures
15% off retail price OR 5% off promotional pricing
N/A
FREQUENCY
Exams
Once every 12 months
Frames
Once every 12 months
Standard plastic lenses
Once every 12 months
Contact lenses (in lieu of standard plastic lenses)
Once every 12 months
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

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: $150 allowance; 15% off balance over $115
Out-of-Network Reimbursement: Up to $92

Disposables

Member Cost In-Network: $150 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

OTHER

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: N/A

Frames

Member Cost In-Network: Once every 12 months
Out-of-Network Reimbursement:N/A

Standard plastic lenses

Member Cost In-Network: Once every 12 months
Out-of-Network Reimbursement: N/A

Contact lenses (in lieu of standard plastic lenses)

Member Cost In-Network: Once every 12 months
Out-of-Network Reimbursement: N/A

*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.)

Eyemed Vision Care Benefit Summary

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