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Vision Plan

The vision plan is an optional benefit administered by EyeMed Vision Care. The plan has a network of participating optometrists and ophthalmologists. If you see an in-network provider, you will have the negotiated costs and copay. However, you may obtain services and materials from any licensed provider. If you use non-network providers, the amounts billed might exceed the maximum reimbursement amounts available under the plan.

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Vision Payment for Benefits

Coverage Tier Monthly Payment for Benefits Bi-Weekly Contributions
Member Only $7.64 $3.82
Member and Spouse $14.42 $7.21
Member and Children $15.18 $7.59
Member and Family $22.26 $11.13

The Internal Revenue Service requires the State of Montana to apply the proper tax treatment (before or after tax) to payments for benefits paid for family members enrolled in medical benefits. Whether your payment for benefits  is deducted on a before or after tax basis depends on if your spouse is qualified or non-qualified for tax purposes. To help you determine your spouse or domestic partner's tax status, we have made several reference materials available.

Covered Services

Covered Services Frequency Coverage from an EyeMed Doctor Out of Network Reimbursement Rural Out of Network Reimbursement*
Eye Exam 12 Months $10 copay $45 allowance Up to $85
Frames 24 Months $125 allowance with 20% discount >$125 $52 allowance Up to $100
Lenses 12 Months      
 Standard - single vision   $20 copay $45 allowance - single vision Up to $45
 Standard - bifocal   $20 copay $55 allowance - bifocal Up to $55
 Standard - trifocal   $20 copay $65 allowance - trifocal Up to $65
 Stanard Progressive (add to bifocal)   $85 copay $55 allowance -progressive Up to $55
 UV Coating   $15 copay N/A N/A
 Tint (solid and gradient)   $15 copay N/A N/A
 Scratch Resistance (standard)   $15 copay N/A N/A
 Polycarbonate   $40 copay N/A N/A
 Anti-Reflective Coating (standard)   $45 copay N/A N/A
 Other add-ons and servcies   20% off retail price N/A N/A
Contact Lenses 12 Months      
 Conventional   $125 allowance with 15% discount >$125 $95 allowance $100 allowance
 Disposable   $125 allowance plus the balance over $125 $95 allowance $100 allowance
 Medically Necessary Contacts**   Paid in full $200 allowance $200 allowance

* To qualify for the enhanced out-of-network reimbursement, employees who are enrolled on the vision plan and who reside more than 50 miles from the nearest network provider, may receive this level of vision benefit.

**Contact lenses that are required to treat medical or abnormal visual conditions, including but not limited to eye surgery (such as cataract removal), visual perception in the better eye that cannot be corrected to 20/70 through the use of eyeglasses, and certain corneal or other diseases of the eye.

Who is Eligible?

Employees, retirees, legislators, COBRA members, and eligible dependents are eligible for this optional benefit.

Using Your EyeMed Benefit

Quality vision care is important to your eye wellness and overall health care. Accessing your EyeMed Vision Care benefit is easy. Simply locate a participating provider, schedule an appointment, present your ID card at the time of service.  The provider will take care of the rest.

Locating your Doctor

Check the online provider locator at www.enrollwitheyemed.com/access for a listing of providers near your zip code. Once enrolled, visit www.eyemedvisioncare.com to view coverage and eligibility information.

Value Added Discounts

Members using a network provider will receive a 20% discount on items not covered by the plan. This discount may not be combined with any other discounts or promotional offers, and the discount does not apply to EyeMed professional services or contact lenses.

Members receive 15% off the retail price or 5% off the promotional price for Lasik or PRK from the US Laser Network, owned and operated by LCA vision. Since Lasik or PRK vision correction is an elective procedure, performed by specially trained providers, this discount may not always be available from a provider in your immediate location. For a location near you and the discount authorization please call (877)5LASER6.

Members receive a 40% discount off a complete pair of eyeglasses purchased and an additional 15% discount off conventional contact lenses once the funded annual benefit has been used.

After initial purchase, replacement contact lenses may be obtained via the internet at a savings and mailed directly to the member. The contact lens benefit allowance is not applicable to this service.

Out-of-Network Providers

Once enrolled, members can access their out-of-network benefit by:

  1. Downloading an Out-of-Network Claim Form from the EyeMed Vision Care website, www.eyemedvisioncare.com, or by calling the Customer Care Center at (866) 723-0513.

  2. Make an appointment with an out-of-network provider you trust as your choice vision care provider.

  3. Pay for all services at the point of care and receive an itemized receipt from the provider office.

  4. Complete the out-of-network claim form, and submit along with receipts to EyeMed Vision Care’s claims department for direct reimbursement.

You may fax your claim form to (866) 293-7373.

Contact EyeMed

EyeMed Vision Care, (866) 723-0513

http://portal.eyemedvisioncare.com/wps/portal/emweb