BCBSIL/EyeMed Vision Plan
Vision PPO plan benefits
This is a summary of Northwestern University's standalone vision plan, available to benefits-eligible faculty & staff. Postdocs should review the Postdoc Benefit Plan website. There is a separate premium charge for this plan.
The vision plan is administered by Blue Cross and Blue Shield of Illinois (BCBSIL). While BCBSIL will be the administrator of the plan, they have contracted EyeMed Vision Care, LLC to provide customer service and claims administration services. The relationship between BCBSIL and EyeMed is that of independent contractors. Through this arrangement with EyeMed, you still have access to the same benefits and to EyeMed’s extensive network of vision care providers.
The vision plan will remain a standalone benefit which means you may choose to participate in the plan regardless of whether you choose any other BCBSIL medical or dental plans offered by Northwestern. You will be assessed a separate premium if you chose to enroll, the same as in past years. Additional information can be found in the BCBSIL certificate of coverage and summary plan description.
- Vision Plan Changes for 2024
- Benefits
- Provider search
- Claim submission
- Monthly premiums
- Mobile app & online account
Benefits
Exams
Exam Type | In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|---|
Eye exam - with dilation, as necessary | $10 copay | Up to $40 |
Contact lens exam - standard fit and follow-up | $10 copay, paid-in-full fit and two follow-up visits | Up to $40 |
Contact lens exam - premium fit and follow-up | $10 copay, 10% off retail prices, then apply $55 allowance | Up to $65 |
Frames
$0 co-pay + $150 allowance, 20% off balance over $150
Standard plastic lenses
Lens Type | In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|---|
Single vision | $10 copay | Up to $40 |
Bifocal | $10 copay | Up to $60 |
Trifocal | $10 copay | Up to $80 |
Lenticular | $10 copay | Up to $80 |
Standard progressive | $75 copay | Up to $60 |
Premium progressive (scheduled) | $95-$120 copay | Up to $60 |
Premium progressive (other) | $75 copay + (80% of charge less $120 allowance) | N/A |
Standard lens options
Lens Option | In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|---|
UV coating | $15 | N/A |
Tint (solid and gradient) | $15 | N/A |
Standard scratch resistance | $0 | Up to $5 |
Standard polycarbonate | $0 | Up to $5 |
Standard anti-reflective coating | $45 | N/A |
Polarized | 20% off retail price | N/A |
Photochromic/transitions plastic | $75 | N/A |
Premium anti-reflective coating (scheduled) | $57-$68 | N/A |
Other add-ons and services | 80% of retail price | N/A |
Contact lenses
Contact Lens Type | In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|---|
Conventional | $0 copay, $200 allowance, plus 15% off balance over $200 | Up to $160 |
Disposable | $0 copay, $200 allowance, plus balance over $200. | Up to $160 |
Medically necessary | $0 (paid in full by plan) | Up to $210 |
Lasik or PRK from US laser network
In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|
15% off retail price, or 5% off promotional price | N/A |
Under the BCBSIL/EyeMed plan, the cost of corrective eye surgery by whether the surgery is completed by an in-network or our-of-network provider.
Frequency per calendar year
Benefit | In-Network Cost (Insight Network) | Out-of-Network Reimbursement |
---|---|---|
Exam | Once every 12 months | Once every calendar year |
Lenses and contact lenses | Once every 12 months | Once every calendar year |
Frames | Once every 12 months | Once every calendar year |
Provider search
To find an in-network provider, visit eyemedvisioncare.com/bcbsilvis, and then select “Click here to find a provider.” Enter your zip code to be connected with eye health experts near you or by calling 855-362-5539. You can additionally find providers by creating an account online or by using the mobile app. If you have an account with EyeMed previously, you cannot use the same email address to create your BCBSIL account.
Claim submission
If using an in-network provider you do not need to submit claims. The provider is responsible for pre-authorizing the claims using your 7-digit employee ID number.
If using an out-of-network provider, submit an BCBSIL/EyeMed vision claim form to the following address for reimbursement: First American Administrators, Inc. Attn: OON Claims, PO Box 8504, Mason, OH 45040-7111
2024 & 2025 Monthly premiums
You | You + Spouse | You + Child(ren) | You + Spouse + Child(ren) |
---|---|---|---|
$10 | $20 | $23 | $28 |
Online Account and Mobile App
You can review your benefits, track claims, and find providers by creating an account online or by using the mobile app. If you have an account with EyeMed previously, you cannot use the same email address to create your BCBSIL account.
If you have an online account with EyeMed or use their mobile app for plan year 2023 or before, you will need to create a new EyeMed online and/or mobile app account AFTER you receive the BCBSIL ID card. Unfortunately, you cannot use the same email address for both accounts. Therefore, you will need to use a different email address from your current/past EyeMed account. EyeMed requires this because your old claims information will still be available under the old account and your new claims information will be available with the new account.