Vision coverage for G.E.H.A's HDHP members
G.E.H.A's HDHP includes generous supplemental vision benefits.
Keep your vision health a priority and receive vision coverage as part of the G.E.H.A High Deductible Health Plan (HDHP) for no additional premium. Whether you have current vision correction needs or you are interested in annual exams, you have access to vision coverage through your health plan.
(If you are a G.E.H.A Elevate, Standard, Elevate Plus or High health member, click Vision coverage for Elevate, Standard, Elevate Plus and High members for information on your vision discounts.)
Your HDHP plan offers you benefits on lenses, frames, and specialty items such as tints, scratch coating, and polycarbonate lenses. Members also receive savings on LASIK at participating U.S. Laser Network locations.
You have access to one of the nation's largest networks of independent eye doctors, and regional and national retail providers including LensCrafters, Pearle Vision and Target Optical. EyeMed also includes online providers such as contactsdirect.com, glasses.com and ray-ban.com.
If you are looking for claim, provider or plan information, sign in to the MyGEHA member portal or contact EyeMed Member Services at 1-877-808-8538.
Vision benefits for you and your family
| Pricing Options | EyeMed Network | Out-of-Network |
|---|---|---|
| Eye examinations | ||
| Including dilation as necessary | $5 copay | Reimbursed up to $45 |
| Additional exam options | ||
| Standard contact lens fit and follow-up | $40 copay | Full retail price |
| Premium contact lens fit and follow-up | No more than 90% of retail price | Full retail price |
| Frames | ||
| Any available frame at provider location | Nothing for frames up to $100 frame allowance. Additionally, a 20% discount applies to any amount over $100. | Reimbursed up to $45 |
| Standard spectacle lens (pair) | ||
| Plastic single vision | $10 copay | Reimbursed up to $25 |
| Plastic bifocal | $10 copay | Reimbursed up to $40 |
| Plastic trifocal | $10 copay | Reimbursed up to $50 |
| Plastic lenticular | $10 copay | Reimbursed up to $80 |
| Progressive lens | $75 copay | Reimbursed up to $40 |
| Premium eyeglass lens (pair) | ||
| Progressive lens |
Tier 1: $95 copay |
Reimbursed up to $40 |
| Eyeglass lens options | ||
| UV treatment, tint (solid and gradient) | $15 copay | Full retail price |
| Standard plastic scratch coating | $15 copay | Full retail price |
| Standard polycarbonate | $40 copay | Full retail price |
| Standard anti-reflective coating | $45 copay | Full retail price |
| Polarized | 80% of the retail price | Full retail price |
| Photochromatic / transitions plastic | $75 copay | Full retail price |
| Premium anti-reflective | Price based on manufacturer | Full retail price |
| Other add-ons | 80% of the retail price | Full retail price |
| Contact lens | ||
| Conventional | $10 copay for lenses costings $110 or less plus 85% on the retail price over $110 | Reimbursed up to $110 |
| Disposable | $10 copay for lenses costing $110 or less plus the retail price over $110 | Reimbursed up to $110 |
| Medically necessary | $10 copay, paid in full, requires pre-approval by EyeMed | Reimbursed up to $250 |
| Laser vision correction | ||
| Laser correction procedure or Photorefractive Keratectomy (PRK) from U.S. Laser Network | 15% off retail price or 5% off promotional price | Full retail price |
| Additional pairs of contacts or glasses | ||
| 40% off the retail price for complete pair eyeglass and 15% off the retail price for conventional contact lenses after the funded benefit has been used | Full retail price |
Vision reimbursement frequency
| Type | Frequency |
|---|---|
| Examinations, spectacle lenses and contact lenses | Once every calendar year |
| Frames | Once every two calendar years |
Vision coverage information
- Upon enrolling in a G.E.H.A HDHP plan, you will automatically receive vision coverage through EyeMed.
- You will receive a separate vision ID card from EyeMed with a benefit summary. For detailed information regarding your vision benefits, review the vision benefits brochure. To request a physical copy, contact Member Services at 1-877-808-8538.
- Find an in-network provider
- Obtain vision care
a. In-network providers will file a claim on your behalf, and you will only be responsible for the remaining balance.
b. For out-of-network services, you will need to pay for the services in full and then submit an out-of-network claim form.
along with a copy of the itemized bill for reimbursement to the following address:
EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111 - To see claim information/plan information, sign in to your MyG.E.H.A member portal and click the My Vision Account button.
- For any questions or assistance, contact EyeMed Member Services at 1-877-808-8538.
Standard/premium progressive lenses not covered – fund as a bifocal lens. Members receive a 20% discount on items not covered by the plan at network providers that cannot be combined with any other discounts or promotional offers. Discount does not apply to network providers' professional services or contact lenses. Limitations and exclusions apply. There are certain brand-name vision materials in which the manufacturer imposes a no-discount practice. Benefit allowances provide no remaining balance for future use within the same benefit frequency. Underwritten by Combined Insurance Company of America, 5050 Broadway, Chicago, IL 60640, except in New York.
The supplemental vision services and pricing options list above are covered outside of the HDHP and are not subject to the Plan deductible. Benefits are based on a calendar year. The Plan allows the member to receive either contacts and frame, or frame and lens services. Any unused portion of the funded benefit cannot be applied to offset the cost of additional services.
This is a brief description of the features of Government Employees Health Association, Inc.'s health plans. Before making a final decision, please read the G.E.H.A Federal brochures which are available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.
Let our benefits experts help you choose a G.E.H.A plan that can work for you.
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