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If you are a Health Savings Advantage high-deductible health plan member, Connection Vision powered by EyeMed offers you and your covered family members professional vision care from qualified EyeMed providers. (If you are a GEHA High or Standard Option health plan member or a GEHA dental plan member, click here for information on your vision benefits.) To locate a participating EyeMed provider in your area, go to www.eyemedvisioncare.com and select the Insight network from the list in the "Locate a Provider" box.
EyeMed includes thousands of network providers including LensCrafters, Pearle Vision, Sears Optical, Target Optical, JCPenney Optical and private practitioners.
The following supplemental vision services are not subject to the HDHP plan deductible. Remimbursement of material benefit is limited to a choice of one pair of frames, spectable lenses or contact lenses. Spectacle lenses are in lieu of contact lenses. Any unused portion of the funded benefit cannot be applied to offset the cost of additional services.
| Vision benefit |
Examination |
Spectacle lenses |
Frames |
Contact lenses |
| Reimbursement frequency |
12 months |
12 months |
24 months |
12 months |
| Eye exam benefits |
EyeMed network provider |
Out-of-network provider |
Eye exam, including dilation as
necessary |
Covered in full after a $5 exam copay |
Reimbursed up to $45 |
Exam options:
Standard contact lens fit and
follow-up
Premium contact lens it and
follow-up |
You pay no more than $55
You pay no more than 90% of retail
price |
You pay full retail price
You pay full retail price |
Frames: Any available frame at provider
location |
Covered in full if retail price of the
frame selected is $100 or less. For
frames costing more than $100, you
pay 80% of retail price over $100. |
Reimbursed up to $45 |
Spectacle lenses (pair):
Standard plastic single vision
Standard plastic bifocal
Standard plastic trifocal
Standard plastic lenticular
Standard progressive lens
Premium progressive lens
|
$10 materials copay
$10 materials copay
$10 materials copay
$10 materials copay
You pay no more than $75
You pay no more than $75 for the
first $120, then 80% of the retail
price over $120.
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Reimbursed up to $25
Reimbursed up to $40
Reimbursed up to $50
Reimbursed up to $80
Reimbursed up to $40
Reimbursed up to $40
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Eyeglass lens options:
UV treatment
Tint (solid and gradient)
Standard plastic scratch coating
Standard polycarbonate
Standard anti-reflective coating
Polarized
Photocromatic / transitions plastic
Premium anti-reflective
Other add-ons
|
You pay $15
You pay $15
You pay $15
You pay $40
You pay $45
You pay 80% of the retail price
You pay $75
Price based on manufacturer
You pay 80% of the retail price
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You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
You pay full retail price
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Contact lenses:
Conventional
Disposable
Medically necessary
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(In lieu of spectacle lenses)
You pay the $10 material copay for
lenses costing $110 or less plus
85% on the retail price over $110
You pay the $10 material copay for
lenses costing $110 or less plus
the retail price over $110
$10 copay, paid in full, requires
pre-approval by EyeMed
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Reimbursed up to $110
Reimbursed up to $110
Reimbursed up to $250
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Laser vision correction: Lasik or PRK
from U.S. Laser Network |
15% off retail price or 5% off
promotional price |
You pay full retail price |
| Additional pairs of glasses or contacts |
40% off the retail price for complete
pair eyeglass and 15% off the
retail price for conventional contact
lenses after the funded benefit has
been used |
You pay full retail price |
Standard/premium progressive lenses not covered – fund as a bifocal lens. Members receive a 20% discount on items not covered by the plan at network providers that cannot be combined with any other discounts or promotional offers. Discount does not apply to network providers' professional services or contact lenses. Limitations and exclusions apply. There are certain brand-name vision materials in which the manufacturer imposes a no-discount practice. Benefit allowances provide no remaining balance for future use within the same benefit frequency. Underwritten by Combined Insurance Company of America, 5050 Broadway, Chicago, IL 60640, except in New York.
You can contact EyeMed Member Services at (877) 808-8538 to:
- Locate a participating provider;
- Request duplicate ID cards;
- Request claim forms;
- Check on claim status;
- Speak to a EyeMed Customer Service representative.
You can also use EyeMed Member Services online by logging into your GEHA Member Web Services account and selecting the link for EyeMed.
GEHA members will receive a separate vision ID card from EyeMed to use for these services.
EyeMed will process all in-network claims systematically. Members will only be responsible for copays and amounts over allowances at time of service.
You will need to pay for out-of-network services in full at the time of service, and submit an out-of-network claim form (PDF) along with a copy of the itemized bill for reimbursement to the following address:
EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111
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