GEHA stands by those who are affected by Hurricane Florence. Customer Care can assist and offer member ID lookups at 800.821.6136. Learn more

Connection Vision Out of Network Claim Form

You only need to complete this form if you are visiting a provider that is not a participating provider in the EyeMed network. Please complete and send this form to EyeMed within one (1) year from the original date of service at the out-of-network provider’s office.