HOW DO I…?

How do I use my benefits?

It’s a lot easier than other kinds of benefits you might have. Just choose an in-network eye doctor from the Enhanced Provider Search, schedule your visit, and go in for care or eyewear. You don’t even need your ID card if you don’t have it—just give them your name. When you stay in-network, we'll handle all the paperwork.

How do I find an eye doctor in network?

Our Enhanced Provider Search has more than 100,000 network providers to choose from.1 You can filter your search to find ones near you that have the frame brands, hours and services you want most. Browse on your PC or download the EyeMed Members App through the Apple App Store or Google Play.

How do I submit a claim?

When you see one of our in-network providers, we take care of all the paperwork. If you visit an out-of-network provider AND have out-of-network benefits as part of your plan, you’ll need to pay during the visit and submit a claim form online for reimbursement. Remember to upload an itemized paid receipt with your name included.  

How do I get an ID card replacement or extra cards?

We send 2 ID cards in the subscriber’s name when you join EyeMed, but you don’t have to have it when you visit your eye doctor. If you lose your card or need extras for your family, you can print a replacement on the member portal. Or to pull up a digital version anytime, anywhere, download the EyeMed Members App through the App Store or Google Play.

How can I see information about my dependents?

If they’re under the age of 18, their information will be listed with yours on the member portal. But, due to privacy rules, dependents 18 or older won’t be listed there. They’ll need to register for their own account.

DIGGING INTO THE DETAILS

What exactly is covered with my EyeMed benefits?

The easiest place to find your benefit information is right here on member portal.

You can also print an ID card and download an Explanation of Benefits. It’s also available on the EyeMed Members App through the App Store or Google Play.

Does EyeMed offer discounts? 

We sure do. At participating in-network providers, members get 40% off an extra pair of eyeglasses or 20% off a partial pair (lenses only or frames only). You also get 20% off non-prescription sunglasses and accessories (These discounts are for in-network providers only. Benefits may not be combined with any discount, promotional offering, or other group benefit plans. Additional limitations and exclusions may apply. Log in to member portal for full details). 

Don’t like wearing glasses or contacts? No problem. We also offer discounts on LASIK laser vision correction. Learn more about LASIK or call 1.800.988.4221 to find a US Laser Network provider.

Can I use my benefits online?

Absolutely. Apply EyeMed benefits in your shopping cart at many popular online eyewear stores, with free shipping, free returns and no paperwork. Visit any of our online network options:
LensCrafters
Target Optical
Glasses.com
ContactsDirect
Ray-Ban 

Can I use FSA funds after my EyeMed benefit is applied?

Sure. A Flexible Spending Account (FSA) is great for paying for a variety of health-related out-of-pocket expenses, including vision care. You can use FSA money for the eye exam copay, prescription glasses or contact lenses (including upgrades), supplies such as contact lens solution, even LASIK surgery. Vision care out-of-pocket costs are also eligible for Health Savings Account reimbursement, though these expenses don’t count toward your annual deductible.

SOME GENERAL QUESTIONS

Does EyeMed sell individual plans?

We do, glad you asked. In fact, we sell individual vision insurance plans in 48 states. Visit http://individual.eyemed.com to see if one is offered in your state. EyeMed Individual and Family plans start at just $5 a month.

I don’t wear glasses and can see fine. Why do I need an eye exam?

Getting an eye exam isn’t just about needing glasses. It’s also about your health. An eye exam can detect eye health problems like glaucoma or cataracts, but it may also help identify signs of serious diseases, like high blood pressure, diabetes and high cholesterol—just to name a few.2 We talk about the vision/health link a lot at www.eyesiteonwellness.com.

How often should I get an eye exam?

Vision changes can happen slowly—you may not even notice it. Annual eye exams are a good rule of thumb unless your doctor suggests more frequent checks; we suggest making it part of your regular preventive care routine. To see what else eye exams can do, visit www.eyesiteonwellness.com.

At what age should my child first visit the eye doctor? 

The American Optometric Association recommends a first eye exam with an optometrist or ophthalmologist between 6 months and 1 year of age.3 The doctor may check for things like nearsightedness, farsightedness, astigmatism, amblyopia (or "lazy eye"), proper eye movement and eye alignment, and how the eye reacts to light and darkness. They also recommend an exam between the ages of 3 and 5, and every year after that. During these exams, many doctors may do a comprehensive eye exam and vision screening tests, depending on the child’s vision needs. To learn more about your child’s vision, visit www.eyesiteonwellness.com.

My child gets a vision screening at school, so there’s no need for an eye exam, right?

A vision screening does not take the place of a comprehensive eye exam. School screenings generally check for color blindness and your child’s ability to see far away. A comprehensive exam will evaluate the entire structure of the eye and allow the doctor to view nerves and blood vessels—small windows into your child’s overall health. Eye doctors will also check for farsightedness, which is more common in younger children.

Can I get the same quality of care with a retail provider as I can with an independent doctor?

Definitely. In fact, many optometrists share space with a retail optical store but operate a separate practice. All of them, wherever they practice, must meet the same state licensing and credentialing requirements. Additionally, one advantage of using a vision carrier, like EyeMed, is that credentials of every in-network eye doctor are thoroughly examined and verified, so you can feel confident you’re getting access to high quality eye care.

How can I find out about my appeal rights?

You have the right to appeal your vision plan’s decision. Learn more about your appeal rights.

What are my rights as a member?

As an EyeMed member, you have certain rights and responsibilities, like the ability to get help in another language if needed. Learn more about EyeMed's Member Bill of Rights.

WHAT DOES THIS MEAN?

Allowance  – The amount of money you can put towards your frames, contact lenses or other purchase. For example, if you have a $100 allowance for frames and you purchase frames that are $150, you pay $50 out-of-pocket.

Anti-reflective coating – By allowing more light into your eye, anti-reflective (AR) coatings are designed to greatly reduce reflections on your lenses that can compromise visual clarity. This means you may see better. An AR coating can also help improve your night vision and make night driving safer. The reduced glare allows others to see your eyes more clearly, too.

Bifocal lenses – Bifocal lenses includes two different areas of vision correction, which are divided by a distinct line that sits horizontally across the lens. The top portion of the lens is used for distance and the bottom portion of the lens is used for closer vision.

Claim – A request for payment of benefits; if you go to an in-network eye doctor, they’ll send this to EyeMed so you don’t have to.

Conventional contact lenses – Contact lenses designed for long-term use (up to one year); can be either daily or extended wear.

Copay – A fixed amount that you pay out-of-pocket at the time of your visit. Check your plan details for your specific copays and benefits.

Dependent – A member’s spouse or child who meets criteria outlined by your specific plan.

Digital lenses  – Digital lenses, also sometimes referred to as high definition or HD lenses are digitally made for accuracy and designed to provide sharper vision, improved peripheral vision and increased clarity to help colors appear more defined and details more vivid. Often, these lenses require additional measurements to personalize the lens for you.

Disposable contact lenses – Contact lenses designed to be thrown away daily, weekly, bi-weekly, monthly or quarterly.

Eligible – Approved to receive benefits.

High index – This super thin lens is best for those with a strong prescription. They are designed to bend light more efficiently and allow light to travel faster through them. Your eye doctor may want you to use a high-index lens depending on your prescription and the frame you choose.

Lens add-on – Any option that doesn’t come with the basic lens, like polycarbonate, scratch-resistant coating, tint and UV coating. You might hear it called an “option” or “upgrade.” Your EyeMed benefits cover most of the cost of these options, while you pay a copay.

Lenticular lens – Used only when a significant vision correction can’t be reached with a traditional lens. This technology involves bonding one lens to the center of another to reach the correct power.

Medically necessary contact lenses – Contact lenses are medically necessary if you’re diagnosed with one of these conditions (ask your eye doctor for more info):

  • Anisometropia of 3D in meridian powers
  • High Ametropia exceeding – 10D or +10D in meridian powers
  • Keratoconus when vision is not correctable to 20/30 in either or both eyes using standard spectacle lenses
  • Vision improvement other than Keratoconus when vision can be corrected two lines of improvement on the visual acuity chart when compared to the best corrected standard spectacle lenses

All requests for medically necessary contact lenses must be submitted by your eye doctor for review and approved by our Medical Director before a claim will be processed.

Network (In-network) – The group of professional providers that we contract with to provide vision care for our members. Our network includes opticians, credentialed optometrists, and ophthalmologists who can provide services, eyeglasses and contacts covered under the plan.

Out-of-network (OON) provider – A professional provider who is not in our network of approved, credentialed providers.

Photochromic lenses – Sometimes also referred to as variable tint or light-adaptive lenses, these lenses change color based on different levels of light. Transitions® lenses are the most popular photochromic lenses. They continuously adapt to changing light conditions and are virtually clear indoors and at night. Plus, they also block UV rays and filter blue light. 

Plastic (basic lens material) – The most widely-used lens material, because it’s lighter than glass.

Polarized lenses – A common lens add-on that cuts down on glare from the sun. Ideal for driving or outdoor activities, especially water and snow sports.

Polycarbonate – A commonly-used lighter, thinner material that helps your lenses resist impact.

Progressive lenses – Bifocal or trifocal lenses with no lines; available in both standard and premium brands.

Provider – An optician, optometrist or ophthalmologist who offers eye care or eyewear to EyeMed members.

Scratch-resistant coating – A common lens coating that helps reduce lens scratches.

Single vision lenses – Lenses prescribed for people who only need help seeing either far away or up close (not both).

Tint – A common lens add-on that reduces the light that enters your eyes; can be added because your eye doctor recommends it or because you simply like the style.

Trifocal lenses – Lenses prescribed for people who need help seeing far away, up close and in between.

Ultra-Violet Coating (UV) – In addition to the UV protection provided by your lens material (think polycarbonate), a UV coating protects your eyes from UV light being reflected off the lens and back into your eye. Over time, prolonged exposure to these rays can be damaging to your eyes.


These materials are designed to provide general information regarding health care topics, do not constitute professional advice nor establish any standard of care, and are provided without representations or warranties of any kind. Quotations, photos and videos are not from actual patients and your experience may be different. Your treating health care professionals are solely responsible for diagnosis, treatment and medical advice. The eye care professionals in your plan are independent practitioners who exercise independent professional judgment and over whom EyeMed has no control or right of control. They are not agents or employees of EyeMed. Eye care professionals do not take the place of your physician.

1 EyeMed Insight network, October 2018.


2 “5 Health Problems Eye Exams Can Detect,” YourSightMatters.com, March, 2016.


3 "Recommended eye examination frequency for pediatric patients and adults," American Optometric Association, https://www.aoa.org/patients-and-public/caring-for-your-vision/comprehensive-eye-and-vision-examination/recommended-examination-frequency-for-pediatric-patients-and-adults. Accessed January 2019.