We offer 2 options for vision coverage through EyeMed.
| BASIC | BUY UP | |||
|---|---|---|---|---|
| NETWORK NAME | ADVANTAGE | INSIGHT | ||
| IN NETWORK | OUT OF NETWORK | IN NETWORK | OUT OF NETWORK | |
| VISION EXAM | $10 copay | Up to $30 | $15 copay | Up to $30 |
| CONTACT LENS EXAM | ||||
| Standard contact lens fit and follow-up | Not available | Not available | Up to $40 | Not available |
| Premium contact lens fit and follow-up | Not available | Not available | 10% off retail price | Not available |
RETINAL IMAGING |
Up to $39 | Not available | Up to $39 | Not available |
| FRAMES | 35% off retail price | Not available | $130 allowance plus 20% off balance over $130 | Up to $65 |
| STANDARD PLASTIC LENSES | ||||
| Single vision | $55 copay | Not available | $20 copay | Up to $25 |
| Bifocal vision | $75 copay | Not available | $20 copay | Up to $40 |
| Trifocal vision | $85 copay | Not available | $20 copay | Up to $55 |
| Lenticular | $105 copay | Not available | $20 copay | Up to $55 |
| Standard Progressive | $135 copay | Not available | $80 copay | Up to $40 |
| Premium Progressive | Not available | Not available | Refer to Fixed Premium Progressive price list | Up to $40 |
| LENS OPTIONS | ||||
| UV coating | $12 copay | Not available | $15 copay | Not available |
| Tint (solid and gradient) | $12 copay | Not available | $15 copay | Not available |
| Standard scratch-resistance | Not available | Not available | $15 copay | Not available |
| Standard polycarbonate | $35 copay | Not available | $40 copay | Not available |
| Standard anti-reflective coating | $40 copay | Not available | $45 copay | Not available |
| Polarized | 30% off retail | Not available | 30% off retail | Not available |
| Other add-ons and services | 30% off retail | Not available | 20% off retail | Not available |
| CONTACT LENSES | ||||
| Conventional | 15% off retail price | Not available | $130 allowance plus 20% off balance over $130 |
Up to $104 |
| Disposable | Not available | Not available | $130 allowance | Up to $104 |
| Medically necessary | Not available | Not available | $0 copay | Up to $200 |
| LASIK Vision Correction | 15% off retail price or 5% off promotional price with U.S. Laser Network only | |||
| ADDITIONAL DISCOUNTS | ||||
| Complete pair-prescription eyeglasses | Not available | Not available | 40% off | Not available |
| Non-prescription sunglasses | 20% off | Not available | 20% off | Not available |
| Remaining balance beyond plan coverage | 30% off | Not available | 30% off | Not available |
| BASIC | BUY UP | |||
|---|---|---|---|---|
| IN NETWORK | OUT OF NETWORK | IN NETWORK | OUT OF NETWORK | |
| EYE EXAM | Once every 12 months | Once every 12 months | ||
| LENSES OR CONTACTS | Unlimited | Once every 12 months | ||
| FRAMES | Unlimited | Once every 24 months | ||
| BASIC | BUY UP | |
|---|---|---|
| EMPLOYEE ONLY | $0.00 | $6.77 |
| EMPLOYEE + SPOUSE | $0.00 | $12.89 |
| EMPLOYEE + CHILDREN | $0.00 | $13.56 |
| EMPLOYEE + FAMILY | $0.00 | $20.13 |
New Hires - 1st of month after 30 days of employment.
Annual Enrollment: January 1st of next calendar year.
Coverage may not be changed during a calendar year unless you have a family status change.
EyeMed providers file claims for you. If your provider does not participate in either of the EyeMed networks, use this form for an out-of-network reimbursement. Claim Form
