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.
|Exam Type||In-Network Cost (Insight Network)||Out-of-Network Reimbursement|
|Eye exam - with dilation, 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 are a $75 copay + (80% of charge, less than $120 allowance)
Standard plastic lenses
|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
|Lens Option||In-Network Cost (Insight Network)||Out-of-Network Reimbursement|
|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|
|Premium anti-reflective coating (scheduled)||$57-$68||N/A|
|Other add-ons and services||80% of retail price||N/A|
|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 balance over $200.||Up to $160|
|Medically necessary||$0 (paid in full by plan)||Up to $210|
Lasik or PRK from US laser network
|In-Network Cost (Insight Network)||Out-of-Network Reimbursement|
|15% off retail price, or 5% off promotional price||N/A|
Frequency per calendar year
|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 12 months||Once every 12 months|
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.
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
2023 Monthly premiums
|You||You + Spouse||You + Child(ren)||You + Spouse + Child(ren)|
With EyeMed’s Know Before You Go out-of-pocket cost estimator, you can get a feel for what you might pay before you even step foot into a store or doctor’s office. The tool includes simple, clear definitions of common lens types and options, all while calculating a range of costs with each click.
So you can feel confident from check-in to check-out. How to guide.
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.