Common Member Questions
Here you'll find the answers to some common questions about your vision plan. Select a category below to view questions about specific topics.
Q. How do I use my benefit?
A. Using your vision benefit at a network provider is easy:
- Locate a provider that services your plan by using the Locate a Provider feature or by calling our Customer Care Center at (855) 652-8686.
- Schedule an appointment.
- Show your ID card at the time of your appointment.
The provider's staff will do the rest! You will only pay for any copays indicated, as well as any applicable amounts over the allowances. Your provider will supply you with these amounts.
The process varies slightly if you decide to use a non-network provider. Visit the Using Your Benefits page for more information.
Q. Do I need to file a claim?
A. No, you will not file claims if you use an in-network provider. If your plan offers out-of-network benefits and you decide to go to an eye care provider not in the vision network, you will need to use an out-of-network claim form.
Q. Where can I find an out-of-network claim form?
A. You can download an out-of-network claim form from the Benefits Details screen here. At the time of service, you will pay the provider in full for the services and materials. Then, mail in the completed claim form along with all receipts to EyeMed for reimbursement.
Q. How can I check on the status of a claim?
A. If you used your benefits at an in-network provider, you should not need to check the status of a claim, as we will work with the provider directly. If you filed an out-of-network claim, please contact our Customer Care Center at (855) 652-8686 to inquire about the status of a claim. Have your member ID available for faster service.
Q. As a subscriber, why do I not see benefit or claim information for my dependent?
A. Per the U.S. Health Insurance Portability and Accountability Act, subscribers are unable to view benefit and claims information for dependents over the age of 18. Information pertaining to any claims for a dependent where the services were rendered prior to the age of 18 are accessible by the subscriber. Dependents over the age of 18 can create an account on the EyeMed Member website to access benefit and claims information.
Q. Can I apply FSA funds to out-of-pocket costs after my vision benefit is applied?
A. Yes. You can use your Flexible Spending Account (FSA) to pay for a variety of health-related out-of pocket expenses, including those associated with ancillary benefits like this plan. Money from the FSA can be applied toward the eye exam copay, out-of-pocket costs for prescription glasses or contact lenses (including upgrades) and supplies such as contact lens solution. Employees can even use FSA funds for LASIK surgery.
Q. I'm interested in receiving my benefit communications electronically. How do I modify my paperless options?
A. If you have paperless options available, you can manage them within the "Manage Profile" page. The link is accessible throughout the site in the upper right corner of the page. From there, you can select to receive paperless Explanation of Benefits documents on this site (as Adobe Acrobat PDF files) and to be notified via email. You can also opt to receive other benefit related communications from us via email. (Note that we will never sell your email address to a third party.)
Q. I currently have paperless options enabled; however, I would like to start receiving my Explanation of Benefits documents via U.S. Mail. How do I modify my paperless options?
A. You can manage your paperless options within the "Manage Profile" page. The link is accessible throughout the site in the upper right corner of the page. From there, you can deselect the option to receive paperless Explanation of Benefits documents on this site (as Adobe Acrobat PDF files). You will then begin receiving these documents via U.S Mail.
You can separately opt to receive other benefit related communications from us via email, or you can also deselect this option within the "Manage Profile" page. (Note that we will never sell your email address to a third party.)
Q. How do I find a provider who accepts my EyeMed plan?
A. You can find a provider by using our online Provider Locator or through the following methods:
- Refer to the Member Brochure you received upon enrolling in the program. It includes a list of providers near your home.
- Call the Customer Care Center at (855) 652-8686 to use our automated voice response system or speak with a representative.
- Ask your preferred eye care provider if he or she accepts EyeMed.
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