EyeMed Vision

Northwestern University's standalone vision plan, available to all benefit eligible employees. There is a separate premium charge for this plan.

Summary Plan Description PDF Document

In-Network Cost
(Insight Network)

Out-of-Network Reimbursement

Exam

$10 co-pay Up to $40
Dilation as necessary $0
Refraction  $0

Exam Options – Contact Lenses 

Standard Fit and Follow-Up $10 copay, Paid-in-full fit and two follow-up visits Up to $40
Premium Fit and Follow-Up  $10 copay, 10% off retail prices, then apply $55 allowance Up to $40

Frames

$0 copay, plus 80% of balance over $130 Up to $65

Standard Plastic Lenses        

Single Vision $10 copay Up to $40
Bifocal $10 copay Up to $60
Trifocal $10 copay Up to $80
Lenticular $10 copay Up to $80
Standard Progressive $75 copay Up to $60
Premium Progressive (scheduled) $101 - $113 copay Up to $60
Premium Progressive (other) $75 copay + (80% of charge less $120 allowance)

Standard Lens Options

UV coating $15 N/A
Tint (solid and gradient) $15 N/A
Standard scratch resistance $0 Up to $5
Standard polycarbonate $0 Up to $5
Standard anti-reflective coating $45 N/A
Polarized 20% off Retail Price N/A
Photochromic/Transitions Plastic $75 N/A
Premium Anti-reflective coating (scheduled) $57 - $68  N/A
Other add-ons and services 80% of retail price N/A

Contact Lenses

 

Conventional $0 copay, plus 85% of balance over $200 Up to $160 
Disposable $0 copay, plus 100% of balance over $200 Up to $160
Medically necessary $0 (paid in full by plan) Up to $210

Lasik or PRK from US Laser Network

85% of retail price 95% of promotional price N/A

Frequency (calendar year)

Exam Once every 12 months Once every 12 months
Lenses or Contact Lenses Once every 12 months Once every 12 months
Frames Once every 24 months Once every 24 months

Claim Submission

If using an in-network provider you do not need to submit claims. The provider is responsible for pre-authorizing the claims using your 7-digit employee ID number.

If using an out-of-network provider, obtain a vision claim form from EyeMed and submit it to the following address for reimbursement:

EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111

Monthly Premiums

You

You+Spouse

You+Child(ren)

You+sps+child(ren)

$7.00

$12.00

$13.00

$17.00

iPhone/Android Phone App

EyeMed has created the vision insurance industry's first app for your iPhone or Android. You can download the app for free and register your account. To register, enter your first name, last name, date of birth, and enter your Northwestern employee ID number in the member ID field (SSNs are not given to EyeMed). Once you log in you can locate an in network provider in your area, view your benefits, see the answer to common questions, and view your ID card. You can use the app to show your ID card at an appointment rather than bringing a printed copy. Just shake your phone from any page in the app and it will pull up your ID card. For additional information on the app, please view the following EyeMed brochure.

Member Phone App