EyeMed Insurance Exclusive Guide to Affordable Eye Care

EyeMed Insurance Exclusive Guide to Affordable Eye Care
EyeMed Insurance Exclusive Guide to Affordable Eye Care | photo courtesy | Insurance Guide 

 

EyeMed is a vision benefits company that offers individual vision insurance plans and LASIK discounts for its members.

You can choose from a variety of benefits, providers, and brands and save money on eye exams, eyewear, and LASIK procedures.

In this article, we will explain what EyeMed insurance covers, how to use your benefits, and how to find an eye doctor.

What is the EyeMed Insurance Company?

EyeMed Insurance stands as a vision benefits company renowned for offering both individual and group plans tailored to eye care and eyewear needs.

Established in 1988 and headquartered in Cincinnati, Ohio, EyeMed operates as a subsidiary of Luxottica, a global leader in the eye care and eyewear industry.

The company boasts an extensive network of in-network providers, comprising independent eye doctors and well-known retail settings.

Such as:

  1. LensCrafters®
  2. Pearle Vision®
  3. Target Optical®.

EyeMed’s comprehensive coverage spans a spectrum of services, encompassing eye exams, prescription eyewear, contact lenses, lens coatings, enhancements, and frames, as well as addressing various eye conditions.

The insurance plan extends its reach to preventive care, specialized services, and emergency eye care.

Additionally, EyeMed goes the extra mile by offering discounts and savings to its members on eye exams, eyewear, and even LASIK procedures.

This commitment to providing a broad range of services and benefits underscores EyeMed’s dedication to meeting the diverse needs of its members.

Who owns EyeMed Insurance?

Based on the findings from the web search, it appears that EyeMed Insurance operates as a subsidiary of Luxottica of America Inc., a prominent global player in the field of eye care and eyewear.

EyeMed Insurance is recognized for providing both individual and group plans tailored to eye care and eyewear needs, boasting an extensive network of in-network providers throughout the United States.

How to contact EyeMed Insurance

Contact Type Phone Number Email Website
Enrollee Customer Service 1-866-723-0513 N/A EyeMed Members and Providers
Product Specialist (844) 243-4584 N/A AARP EyeMed Individual Vision Insurance
Broker N/A N/A EyeMed Brokers
Employer N/A N/A EyeMed Employers

What does EyeMed Insurance cover?

EyeMed coverage includes:

  • Vision Care Services: Eye exams, prescription eyewear, contact lenses, lens coatings and enhancements, and frames.
  • Eye conditions: glaucoma, cataracts, macular degeneration, diabetic retinopathy.
  • Preventive Care: Routine eye exams and preventive screenings.
  • Specialized Services: LASIK surgery, vision therapy.
  • Network Providers: In-network eye care providers.
  • Out-of-Network Coverage: Out-of-network coverage with higher co-payments and deductibles.
  • Insurance Limits: Coverage limits for different types of services and providers.

What are the benefits of EyeMed? 

EyeMed benefits include:

  • Coverage Details: You can view your coverage details online or on the mobile app. You can also check your copays and deductibles for different types of services and providers.
  • Savings Summary: You can view your savings summary online or on the mobile app. You can see how much you have saved on eye exams, eyewear, and LASIK procedures with your benefits.
  • Special Offers: You can receive special offers from participating in-network providers via text or email. You can also access savings on hearing exams and hearing aids with your benefits.
  • Online Shopping: You can shop online at popular retail sites like LensCrafters, Target Optical, Ray-Ban, Oakley, Glasses.com, and ContactsDirect with your benefits. No paperwork is required.

How to Use Your EyeMed Benefits

To use your benefits with EyeMed insurance:

  • Filing a Claim: If you need to file a claim for an out-of-network service or provider, you need to submit a claim form within 90 days of the service date. You also need to provide proof of payment or authorization from your provider. You can file a claim online or by mail.
  • Reimbursement Process: If you file a claim within 90 days of the service date, you will receive reimbursement within 30 days of filing. If you file a claim after 90 days of the service date, you will not receive reimbursement unless there is an exception or a dispute.
  • Policy Exclusions: Some services or providers are excluded from your coverage due to certain reasons. For example:
    • Cosmetic procedures are not covered unless they are medically necessary for correcting a vision problem caused by an injury or disease.
    • Non-prescription eyewear is not covered unless it is prescribed by an eye doctor for medical reasons such as glaucoma or cataracts.
    • Experimental treatments are not covered unless they are approved by the FDA or other regulatory agencies.

How to Find an Eye Doctor

To find an eye doctor with EyeMed insurance:

  • Provider Locator: You can use the provider locator tool on their website or the mobile app to find in-network eye care providers near you. You can filter by location, specialty, gender preference, language preference, hours of operation, and more.
  • Enhanced Provider Search: You can use the enhanced provider search tool on the website or the mobile app to find in-network eye care providers that offer specific services such as LASIK surgery or vision therapy. You can filter by location, specialty, gender preference, language preference, hours of operation, and more.

Emergency Eye Care

If you have an emergency that requires urgent eye care, such as:

  • If you notice a sudden onset of severe pain, redness, swelling, or discharge in one eye or both eyes that may indicate infection, injury, or glaucoma, or a sudden loss of vision or color perception in one eye or both eyes that may indicate a stroke, brain tumor, or detached retina, you should seek immediate medical attention.

You should call 911 if you have any signs of emergency eye care.

You should also contact EyeMed customer service at 844.873.7853 if you have any questions about your coverage or benefits.

EyeMed will cover emergency services such as:

Emergency room visits for diagnosis and treatment of acute conditions affecting both eyes; and emergency surgery for refractive errors, such as LASIK surgery, if medically necessary.

  1. You may be responsible for some co-payments depending on your plan type and provider network status.
  2. You may also be eligible for some savings, depending on your plan type and provider network status.
  3. You should contact EyeMed customer service at 844.873.7853 if you have any questions about emergency service coverage.

FAQs

What is EyeMed Insurance?

EyeMed Insurance stands as a vision benefits company offering both individual and group plans tailored to eye care and eyewear needs.

With a range of benefits, providers, and brand options, you can enjoy cost savings on eye exams, eyewear, and LASIK procedures.

How to use EyeMed Benefits? 

To leverage your EyeMed benefits, locate an in-network eye care provider using the website or mobile app’s provider locator tool.

Schedule an appointment, receive services, and stay worry-free about ID cards or claim filing when you stay in-network.

Online or on the mobile app, access your coverage details, savings summary, and exclusive offers.

What does EyeMed cover?

EyeMed encompasses a broad spectrum of services, including:

  1. eye exams
  2. prescription eyewear
  3. contact lenses
  4. lens coatings

And enhancements

  1. frame
  2. eye condition treatments
  3. preventive care
  4. specialized services
  5. emergency eye care.

Out-of-network services are also covered, albeit with higher co-payments and deductibles depending on your plan type.

How do I find an eye doctor in the EyeMed network?

Locate in-network eye care providers effortlessly using the enhanced provider search tool on the website or mobile app.

Filter your search by location, specialty, gender preference, language preference, and hours of operation.

Whether browsing on your PC or downloading the EyeMed Members App from the Apple App Store or Google Play, you have convenient options.

How do I submit a claim for out-of-network services?

In the event of seeking services from an out-of-network provider with applicable out-of-network benefits, pay at the time of service and complete a claim form for reimbursement from EyeMed.

Ensure you provide proof of payment or authorization from your provider. File your claim online or by mail within 90 days of the service date.

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