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Avesis
National Network of Vision Care ProvidersAvesis national network of vision care providers offers its members eye care programs to meet their vision care needs. These plans have been specifically designed to provide you and your covered family members with quality professional care and optical materials, all at a tremendous savings to you.
How to use the Avesis Vision PlanIn-NetworkOut-of-Network-
Call 1-800-828-9341 if you need assistance selecting an Avesis Participating Provider, or if you need clarification on your vision care plan.
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Call the provider and identify yourself as an Avesis member.
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Schedule an appointment with the Avesis participating provider.
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Present your Avesis ID card, pay any expenses that are not covered at the Avesis participating provider's office.
When you choose to receive services from a non-participating provider, you pay the provider and submit an itemized statement to Avesis for reimbursement according to the Out-Of-Network Reimbursement Schedule.
You must submit the claim within 3 months from the date of service, otherwise, there will be no reimbursement. When filing a claim, you must provide the following information:
Your name, your employee ID #, patient's name, patient's date of birth, your mailing address and the group number.
Avesis Vision Plan - Limitations & ExclusionsLimitationsThis plan is designed to cover eye examinations and corrective eyewear. It is also designed to cover visual needs rather than cosmetic options. Should the member select options that are not covered under the plan, as shown in the schedule of benefits, the member will pay a discounted fee to the Avesis participating provider. Benefits are payable only for expenses incurred while the group and individual member's coverage is in force.
ExclusionsThere are no benefits under the plan for professional services or materials for the following:
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Orthoptics or vision training
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Subnormal vision aids
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Plano (non-prescription) lenses, Plano (non-prescription) sunglasses
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Two pair of lenses in lieu of bifocal or trifocal lenses
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Any medical or surgical treatment of eye disease or injury
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Replacement of lost of broken lenses or frames, except when the member is normally eligible for services
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Any eye examination required by an employer as a condition of employment
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Services or materials provided as a result of any Worker's Compensation Law or similar legislation, or services or materials obtained through or required by any governmental agency whether Federal, State or subdivision thereof.
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