Vision Care Plan

Exclusions and Limitations 

Your Vision Care Plan covers a wide range of services. However, there are certain services, procedures, and supplies that the Plan does not cover. 

VISION CARE PLAN EXCLUSIONS
Your Vision Care Plan will not pay for: 

  • orthoptic or vision training, subnormal vision aids and any associated supplemental testing; Aniseikonic lenses;
  • medical and/or surgical treatment of the eye, eyes or supporting structures;
  • any vision examination, or any corrective eyewear required by a Policyholder as a condition of employment; safety eyewear;
  • services provided as a result of any Workers’ Compensation law, or similar legislation, or required by any governmental agency or program, whether federal, state or subdivisions thereof;
  • plano (non-prescription) lenses;
  • non-prescription sunglasses;
  • two pair of glasses in lieu of bifocals;
  • services or materials provided by any other group benefit plan providing vision care;
  • services rendered after the date a covered person ceases to be covered under the Policy, except when vision materials ordered before coverage ended are delivered, and the services rendered to the covered person are within 31 days from the date of such order;
  • lost or broken lenses, frames, glasses, or contact lenses will not be replaced except in the next benefit frequency when vision materials would next become available;
  • services rendered by an unlicensed provider, or any provider who is operating outside the scope of his or her license; and
  • services that are not required for the covered person’s visual health and welfare. 

If you are not sure whether a given vision care service, procedure, or supply is covered by the Plan, you should contact EyeMed Vision Care Member/Patient Services at 1-877-829-5067

The Administrative Information section of this Summary Plan Description (SPD) is incorporated into this section by reference. The Administrative Information section contains additional important information about your Vision Care Plan benefits, including your rights as a plan participant under the Employee Retirement Income Security Act of 1974 (ERISA).