Were EyeMed Our member experience is off the charts 2 Its the vision benefit solution that members appreciate most The importance of eye exams From our first steps to our first grandchild vision affects every aspect of our life at every stage in life ID: 783137
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Slide1
Nice to see you again Texas A&M University System
We’re EyeMed
Slide2Our member experience is off the charts!
2
It’s the vision benefit solution that
members appreciate most!
Slide3The importance of eye exams
From our first steps to our first grandchild, vision affects every aspect of our life, at every stage in life
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Slide4See what comes with our eye exams
The annual eye exam recognized as a primary entry point into the health care system
EyeMed requires the submission of all applicable ICD-9 diagnosis codes for claims submission
Dilation is a key procedure for diagnosis of diabetes, hypertension and heart disease
Dilation is included in all exams at no additional charge but at the determination of the provider
EyeMed Vision Care’s panel conducts comprehensive eye examinations to diagnose or detect existing conditions of the eye and vision system.
Tests and procedures of a comprehensive exam include:
Case History
Evaluation of visual system’s status
Refractive Status
Binocular Function
Assessment, diagnosis and treatment plans
Contact Lens Exam & Evaluation (when appropriate)
Slide5We give our members options
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FASHION
FUNCTION
ECONOMIC
PREMIUM
Whether you choose a provider based on your schedule, style or value,
…no matter what, we have you covered!
Slide6You are free to choose vision care…
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When
Where
How
Convenient locations in or near major shopping centers with longer hours on nights and weekends
Appointment
times that fit your schedule
We have you covered from coast to coast with more than 65,000
provider access points including over 4,900 retail locations including Lenscrafters, Pearle Vision, Target Optical, Sears Optical, JC Penny’s Optical and many more!
No restrictive “collections” or “formularies” Choose from either glasses or contact lenses
Take your RX anywhere in-network to have it filled
And rest assured, all benefits & discounts are applied consistently in our network
Slide7Check out our plan design
Feature
In-Network
Co-payments and Coverage Options
Out-of-Network Reimbursement Schedule
Eye Examination
$10 co-pay
Up to $50
Exam Options:
Standard Contact Lens Fit & Follow-Up
Premium Contact Lens Fit & Follow-Up
Covered in full
10% off Retail, then apply $40 allowance
$40
$40
Frame
$0 Co-pay, $130 Allowance, 20% off balance over $130*
Up to $90
Standard Plastic Lenses:
Single Vision
Bifocal
Trifocal
Lenticular
Standard Progressive
Premium Progressive
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-Pay, $120 allowance, 20% off remaining balance
Up to $50
Up to $70
Up to $100
Up to $100
Up to $70
Up to $70
Contact Lenses
(in lieu of eyeglass lenses):
Conventional
Disposable
Medically Necessary
$0 Co-pay, $150 Allowance , 15% off balance over $150
$0 Co-pay, $150 Allowance , plus balance over $150
$0 Co-pay, Paid-in-Full
Up to $150
Up to $150
Up to $210
Frequency
Exam
Lenses or Contact Lenses
Frame
Once every 12 months per plan year
Once every 12 months per plan year
Once every 24 months per plan year
Slide8See all the details
Covered in full:
scratch coating , standard progressive
l
enses & polycarbonate lenses for children. Additional benefits include:
Premium Progressive Lenses: $41-$53 copay Tint (Solid or Gradient): $15 copay
UV Coating: $15 copay Polycarbonate- Adult: $40 copay Standard Anti-Reflective: $45 copay Premium Anti-Reflective: $57-$68 copay
Transition: $75 copayYour employees get even more:
Exclusive to EyeMed: 40% off unlimited additional pairs
Up to 60% discount on popular lens options not covered by the plan40%-60% off contact lens fit & follow-up20% off any item not covered by the plan20% off any frame balanceLasik Discount – 15% off retail pricing or 5% off any promotional price
at U.S. Laser Vision locations
Lens options are also available at fixed pricing to EyeMed members
Slide9Simple steps to access the benefit
Slide10Helpful communication – including an ID card
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eyemed.com
b
enefit summary
open enrollment
welcome packet
Slide1111
Award-winning service day & night
362
days a year, we’re here
Monday – Saturday:
7:30 – 11 p.m. ET
Sunday: 11 – 8 p.m. ET
99.5
%
1
st call resolution rate14sec. avg. speed of answerSkill-based routing so your calls are answered by the right vision benefits expert every time
Certified Center of Excellence by Benchmark Portal 3 years in-a-row
We are accessible,
helpful,
& great at what we do.
Slide12Who knew vision can be easy, fast &…mobile?
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Online exam scheduling*
Linked directly
from
our provider
locator at eyemed.comMobile-optimized web
Locate a provider
View ID cardView benefitsContact EyeMed
Find answers to common questionsEyesiteonwellness.comOne-stop reference library, videos &
downloadable materialsRegularly updated materials to incorporate in company communicationsWellness calendar allowing employers to customize the frequency of communications
*Available at participating providers
Slide13Any questions?