For EXISTING Plan Members
Please sign in to access this area using your Primary Member’s Unique ID number and Date of Birth.
If you have forgotten the Unique ID, please contact Community Eye Care at 888-254-4290.
CONTACT LENS FITTINGS
The Community Eye Care vision benefit includes coverage for the three types of contact lens examinations --- new fittings, re-fits, and evaluations. Each of these is described below:
A new contact lens fitting is a type of exam that's performed in a member who has never before worn contact lenses. Its purpose is to determine the ideal contact lens type, size and curvature.
A re-fit is performed in either of two situations:
- an individual who previously wore contact lenses is resuming contact lens wear after a lengthy hiatus; and
- an individual who already wears contact lenses is either switching to a different type of lens (e.g. gas-permeable lenses, toric lenses, bi-focal lenses) or is in need of a change in lens diameter or base curve.
A contact lens evaluation refers to an annual evaluation that's performed in an existing contact lens wearer for the purpose of renewing their prescription or adjusting the strength of their prescription. The member is not new to contact lenses, nor are they changing to a different type of lens, a different lens diameter, or a different base curve.
You can access your vision benefit either in-network or out-of-network. If you obtain your eye exam from an out-of-network doctor, you will not be eligible for another exam until the next plan year. Similarly, if you obtain your full eyewear benefit from an out-of-network provider, the eyewear benefit will not renew until the next plan year. Note, however, that if you obtain only a portion of your eyewear benefit from an out-of-network provider, you are permitted to utilize the remainder of the eyewear benefit during the same plan year.
By using an in-network provider, you enjoy the greatest value and savings. Members who opt to see an out-of-network provider must pay the provider's full charges at the time of the visit, obtain a receipt, and file a claim within 180 days of the date of service to Community Eye Care. Your reimbursement would be based on your out-of-network allowance.
Non-Prescription Eyewear Policy
Most providers in the Community Eye Care network allow vision plan members to use their eyewear allowance for the purchase of non-prescription eyewear. However, CEC providers are not required to extend coverage to non-prescription items, and a few have opted to restrict coverage to prescription eyewear.
Before using your eyewear allowance to obtain non-prescription eyewear, please check with the provider to make sure that this is permissible.
Vision plan members may sometimes encounter sales promotions (such as “two-for-one sales” or steep discounts) that are offered by in-network providers. While we prefer that providers allow members to use their CEC vision benefit in conjunction with these sales promotions, we cannot force providers to do so. Please recognize that some providers will permit only one of the following at a single visit: a) the CEC benefit, or b) the sales promotion.
If you encounter this situation and opt to take advantage of the sales promotion, you do not lose your CEC benefit. On the contrary, you remain eligible for the benefit, and you have the option of accessing it at a later date either through the same provider or through a different provider.
COORDINATION OF BENEFITS
Coordination of benefits is not permitted, either with respect to other vision plans or with respect to vision benefits under health insurance plans.