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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.

Benefits

Exams

BCBSIL/EyeMed eye exam cots by exam type and whether the provider is in or out of network.
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

BCBSIL/EyeMed cost of standard plastic lenses by lens type and whether or not the supplier is in or out of network.
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

BCBSIL/EyeMed lens option costs by whether the supplier is in or out of network.
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

Under the BCBSIL/EyeMed plan, the cost of contact lenses by contact lens type and whether the supplier is in or out of network.
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

Exam Types
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

How frequently BCBSIL/EyeMed covers benefits for in-network and out-of-network goods and services.
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

BCBSIL/EyeMed monthly premiums by family members insured.
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.