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EyeMed Vision

This is a summary of Northwestern University's standalone vision plan, available to all benefits-eligible employees. There is a separate premium charge for this plan. Additional information can be found in the EyeMed certificate of coverage and summary plan description.

Benefits

Exams

EyeMed eye exam cots by exam type and whether the provider is in or out of network.
Exam Type In-Network Cost (Insight Network) Out-of-Network Reimbursement
Eye exam - with dialation, as necessary $10 copay Up to $40
Contact lens exam - standard fit and follow-up $10 copay, paid-in-full fit and two follow-up visits Up to $40
Contact lens exam - premium fit and follow-up $10 copay, 10% off retail prices, then apply $55 allowance Up to $65

 

Frames

Frames are a $75 copay + (80% of charge, less than $120 allowance) 

Standard plastic lenses

EyeMed cost of standard plastic lenses by lens type and whether or not the supplier is in or out of network.
Lens Type In-Network Cost (Insight Network) Out-of-Network Reimbursement
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) $95-$120 copay Up to $60
Premium progressive (other) $75 copay + (80% of charge less $120 allowance) N/A

 

Standard lens options

EyeMed lens option costs by whether the supplier is in or out of network.
Lens Option In-Network Cost (Insight Network) Out-of-Network Reimbursement
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

Under the EyeMed plan, the cost of contact lenses by contact lens type and whether the supplier is in or out of network.
Contact Lens Type In-Network Cost (Insight Network) Out-of-Network Reimbursement
Conventional $0 copay, $200 allowance, plus 15% off balance over $200 Up to $160
Disposable $0 copay, $200 allowance, plus 100% off balance over $200 Up to $160
Medically necessary $0 (paid in full by plan) Up to $210

 

Lasik or PRK from US laser network

Under the EyeMed plan, the cost of corrective eye surgery by whether the surgery is completed by an in-network or our-of-network provider.
In-Network Cost (Insight Network) Out-of-Network Reimbursement
15% off retail price, or 5% off promotional price N/A

 

Frequency per calendar year

How frequently EyeMed covers benefits for in-network and out-of-network goods and services.
Benefit In-Network Cost (Insight Network) Out-of-Network Reimbursement
Exam Once every 12 months Once every 12 months
Lenses and contact lenses Once every 12 months Once every 12 months
Frames Once every 24 months Once every 24 months

 

Provider search

To find an in-network provider, visit the EyeMed website. Then click on "Find a Provider" from the green menu. Select the "Insight" network when searching.

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, submit an EyeMed vision claim form to the following address for reimbursement:

EyeMed Vision Care

Attn: OON Claims

P.O. Box 8504

Mason, OH 45040-7111

Monthly premiums

EyeMed monthly premiums by family members insured.
You You + Spouse You + Child(ren) You + Spouse + Child(ren)
$11 $21 $25 $30

 

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 EyeMed mobile app brochure.