Benefit Reference Guide - The School District of Palm Beach County

Replacement Contact Lens by Mail Service
EyeMed
How does the program work?
Three Easy Steps
EyeMed Vision Care offers replacement contact lenses by mail. This
service option is available to all EyeMed Vision Care members!
All EyeMed members have the option to purchase replacement
contact lenses for great prices over the Internet, and have them
mailed directly to your home!
If you are in need of replacement contact lenses and wish to
utilize the convenience of having the lenses mailed to your
home, it’s as easy as 1,2,3 . . .
1. Log on to www.eyemedcontacts.com to order replacement
lenses.You must have a valid contact lens prescription to order
lenses from the site.
2. Enter the name of your vision care provider, type and quantity of
lenses
you wish to purchase, as well as the requested billing and
shipping information. As this service is not part of your core
benefit, expenses from the service are not a covered benefit –
and are therefore not reimbursable.
3. Eyemedcontacts.com will request the specific prescription
from your eye care provider. Upon approval from your provider,
your lenses will be mailed directly to your home.
Because quality of care is our first priority, this program is for
replacement lenses only.
If you have a contact lens allowance with your core benefit, it is not
applicable to the replacement lens service. You should always receive
a comprehensive contact lens exam and your initial pair of lenses
from your EyeMed professional provider to ensure proper fit and
follow-up care.
Can I submit expenses from this service
as an Out-of-Network claim?
Yes. For instance, if you are new to the plan, already have a valid
and current contact lens prescription and have an out-of-network
contact lens benefit, it may be applied to this service. The member
should follow the normal out-of-network claim process to be
reimbursed.
OUT-OF-NETWORK BENEFIT
VISION SERVICES
Member REIMBURSEMENT**
Examination with Up to $35
dilation as necessary
Frame: Up to $60
Lenses (one pair)
Single Vision Up to $25
Bifocal Up to $40
Trifocal Up to $55
Standard Progressive Up to $55
Premium Progressive Up to $55
Contact Lenses (includes materials; only in lieu of lenses)
Conventional Up to $100
Disposable Up to $100
Medically Necessary Up to $200
No coverage for lens options, or laser vision procedures outside
the U.S. Laser Network.
** Co-payment does not apply
Once you have enrolled in the vision plan, for or more details about
the program, please visit eyemedvisioncare.com, or call our
Customer Care Center at 1-866-723-0514.
Visit the EyeMed website at
www.eyemedvisioncare.com
and choose the “Select” network and
enter your zip code to find a provider.
For the most updated listing, (after you are a member) visit our
website at www.eyemedvisioncare.com or call
1-866-723-0514.
Did you read about...
• Vision plan details?
• Mail-order contact lenses?
• How to locate a provider?
*Some states do not require the provider to release the prescription.
www.myFBMC.com
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