As with all managed care organizations, EyeMed is required to follow COVID-19 guidance and protocols provided by the Centers for Disease Control and Prevention (CDC), and state and local public health and insurance departments.

Your state is still currently under a mandate to provide essential services only.

As a result, we recommend you follow CDC guidelines regarding routine eye exams, including postponing routine visits. Circumstances may arise where you need to receive new glasses, lenses, or contact lenses. This updated FAQ will provide some additional clarification.

WHAT IS THE DIFFERENCE BETWEEN NON-ESSENTIAL and ESSENTIAL EYE CARE SERVICES?

Non-essential services include routine eye care services such as receiving your annual eye exam. Other routine services may be minor irritants such as dry or itchy eyes or getting fitted for contacts for the first time. Essential services are urgent eye care needs, like sudden vision changes or vision loss, eye trauma, pink eye/conjunctivitis or symptoms that significantly impact or interfere with day-to-day activities.

CAN I STILL USE MY EYEMED BENEFIT?

Yes. EyeMed is committed to maintaining service and helping you manage through these challenging times. We recommend you follow CDC guidelines regarding routine eye exams, including postponing routine visits. However, CISA has identified optometry as an essential service. Circumstances may arise where you need to receive new glasses, lenses, or contact lenses.

Please review the various scenarios under, “HOW DO I PURCHASE GLASSES OR CONTACT LENSES?”

IS THERE EYE HEALTH INFORMATION AVAILABLE REGARDING COVID-19?

Yes. You can find the most up-to-date information at https://eyemed.com/en-us/coronavirus-eyehealth.

HOW DO I PURCHASE GLASSES OR CONTACT LENSES?

There are four scenarios to consider if you’re in need of a new complete pair of eyeglasses or replacement lenses. Please review the criteria below. Of course, if you have any questions, our Customer Care Center is available at 1.866.933.3633 (or your group-specific number on your ID card) to assist you. Please review the criteria below:

1)    If you have a valid prescription and have a state-mandated stay-at-home order, or you can’t leave due to illness/doctor’s recommendation

If you have a valid prescription, your prescription for eyeglasses should be valid unless there’s a documented expiration date. Our recommendation is to utilize online, in-network options, including Glasses.com, Ray-Ban.com, LensCrafters.com and TargetOptical.com. See “CAN I ORDER EYEWEAR/CONTACTS ONLINE USING MY BENEFITS?”

If you’ve experienced any vision or medical changes, and you’re not certain if your prescription is still correct, we encourage you to contact your existing doctor (last office visited). See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

2)    If you have current eyeglasses, your frame or lenses are broken, and you’d like replacement (duplicate) lenses

It is possible for an eye care professional to remake new lenses (or duplicate lenses) from your current lenses. In these cases, we encourage you to contact your existing eye doctor (last office you visited) first. However, another eye care professional may be able to duplicate lenses from your existing glasses as well. See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

3)    If you have no prescription and you’ve lost your eyewear, and you can leave your home

In many states where stay-at-home orders have been issued, optometry may still be considered an essential service in most states. However, routine care is discouraged given the circumstances, but this may qualify as an essential service. In certain states, you may be able to visit an eye doctor to receive an eye exam and obtain new glasses. See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

4)    If you have no eyewear, you have no current prescription, and you can’t leave the home due to illness/doctor’s recommendation

If you meet the criteria above, please contact our Customer Care Center directly at 1.866.939.3633 (or your group-specific number on your ID card). You may be eligible to receive an emergency pair of replacement Adlens Adjustable Glasses (subject to availability). These temporary, emergency glasses can be adjusted to switch focus for reading, computer and distance.

IF YOU REQUIRE NEW CONTACT LENSES:

Please be aware that federal law, Fairness to Contact Lens Consumer Act, mandates the guidelines for issuing and distributing new contact lenses. As it stands today, these federal guidelines may temporarily limit your ability to obtain new contact lenses. Below are a few options:

1)    If you have a valid prescription and it’s less than 12 months since your exam

If you’ve received an eye exam within the last 12 months our recommendation is to utilize online, in-network options, including Glasses.com, ContactsDirect, Ray-Ban.com, LensCrafters.com and TargetOptical.com. See “CAN I ORDER EYEWEAR/CONTACTS ONLINE USING MY BENEFITS?”

If you’ve experienced any vision or medical changes, and you’re not certain if your prescription is still correct, we encourage you to contact your existing doctor (last office visited). See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

2)    If you have a prescription but it is greater than 12 months since your last exam

Your current eye doctor (last office visited) may be able to extend a prior prescription. We first encourage you to reach out to your current eye doctor (last office visited) to consider your current vision and medical needs and potentially obtain an extended prescription. See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

If you are unable to reach your current eye doctor for an extended prescription consider utilizing an online, in-network provider, including: ContactsDirect, LensCrafters.com and TargetOptical.com. You will be asked to complete information online, including submitting your last prescription. Once they receive your information, federal guidelines require them to contact your eye doctor (last office visited) to attempt to deny or approve your order.

If neither of the options above enable you to receive new contact lenses, federal guidelines are likely to prevent you (at this time) from purchasing new contact lenses. In this situation, you may wish to consider temporarily switching to glasses. Eyewear (glasses) may often be able to be produced from a valid prescription older than 12 months so long as it does not include an expiration date, or in the event it does, it has not expired. If you’re interested in new glasses, we recommend utilizing any of the online, in-network options highlighted above. See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

3)    If you have no prescription and you can leave your home

In many states where stay-at-home orders have been issued, optometry may still be considered an essential service in certain states. However, routine care is discouraged given the circumstances, but this may qualify as an essential service. In certain states, you may be able to visit an eye doctor to receive an eye exam and obtain your new prescription. See “WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?”

4)    If you wear contacts, have no current prescription, do not have glasses and you can’t leave the home due to illness/doctor’s recommendation

Unfortunately, you will likely not be able to replace your contact lenses at this time since federal law require a valid prescription less than 12 months old. Please contact our Customer Care Center directly at 1.866.939.3633 (or the group-specific number on your ID card). If you meet the criteria above, you may be eligible to receive an emergency pair of replacement Adlens Adjustable Glasses (subject to availability). These temporary, emergency glasses can be adjusted to switch focus for reading, computer and distance.

WHAT ARE MY OPTIONS FOR CONTACTING A PROVIDER?

You should expect that numerous provider offices will be impacted due to federal, state and local restrictions, staffing, safety and other conditions. We highly recommend that EyeMed members call your provider directly to verify modified location hours or closing. You have 24-hour access to provider contact information via our provider locator on EyeMed.com or our mobile app (available on iPhone and Android). You may also call our Customer Care Center directly at 1.866.939.3633 (or your group-specific number on your ID card).

CAN I ORDER EYEWEAR ONLINE USING MY BENEFITS?

Yes. You have multiple options to order prescription eyewear and contact lenses online using your EyeMed benefits. Please review the various scenarios under, “HOW DO I PURCHASE GLASSES OR CONTACT LENSES?” If you meet the qualifications, you have multiple online, in-network options including: Glasses.com, ContactsDirect, Ray-Ban.com, LensCrafters.com and TargetOptical.com. It’s easy to order, your benefits are applied automatically, and your glasses will be delivered right to your home. Understanding the circumstances, many of these online providers are offering free expedited shipping and no-cost returns for extra convenience. *Check with online providers to verify available offers.

WHAT IF I VISIT AN OUT-OF-NETWORK PROVIDER?

We highly encourage EyeMed members to use an in-network provider, including our online options—if possible. 97% of EyeMed members use an in-network provider.  If you’d like help finding a nearby in-network provider, please contact our Customer Care Center at 1.866.939.3633. We’ll help direct you to an in-network provider, as well as help verify their hours of operation.

If an in-network provider isn’t an option, the best option to assure the fastest turnaround for an out-of-network claim is to submit your claim electronically (verses submitting a paper claim) by signing into your member account on eyemed.com.

ARE TELEHEALTH SERVICES AVAILABLE FOR EXAMS?

No in-home solutions are available for eye exams. At this point in time, telehealth exams for eye health still require an office visit and are available in very few locations.

WHAT EYEMED SERVICE OPTIONS DO I HAVE?

COVID-19 will make each of our lives more challenging. But if you have questions, know that we’re here for you with three service options. Our Customer Care Center is available during normal business hours at 1.866.939.3633. They can direct you to a nearby in-network provider, as well as help you determine their potentially modified hours of operation. You also have 24/7 service via eyemed.com and our mobile app (available on both iPhone and Android). Using these tools, you have access to provider contact information, your benefits and eligibility, and more. If you prefer to self-service online, we highly encourage you to identify your provider’s contact information via our provider locator, and then call the provider office directly to verify their potentially modified hours of operation.