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Frequently Asked Questions About Vision Care Insurance |
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| Q) | Why should I use a contracted vision provider rather than one that is not a member of the TruAssure network? |
| A) | Using a contracted vision provider allows you to take advantage of negotiated contract rates with providers, thus lowering out-of-pocket costs. Most TruAssure plans allow for Out-of-Network claim reimbursement for covered services, although your out-of-pocket expense may be more. |
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| Q) | Why do I need to mention EyeMed Vision Care when I’m making an appointment or visiting my provider? |
| A) | EyeMed Vision Care administers TruAssure’s vision care plans so your provider needs to know that he/she should contact EyeMed to verify your benefits. |
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| Q) | Why do I need an eye examination, especially if I haven’t had a prescription change or I don’t have a vision problem? |
| A) |
An eye examination means more than getting a prescription – it evaluates your eye
health and is critical in the early detection of several vision and health-related
conditions, including glaucoma, diabetes, cataracts, and hypertension. And, because
early detection is the key for treatment, periodic eye examinations play a vital
role in ensuring the health of your eyes. Eye examinations are also important for the health and safety of children. The American Optometric Association recommends that children receive their first eye examination from an eyecare professional as early as six months of age. Afterwards, your provider will advise you when your child’s next eye examination should be scheduled. |
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| Q) | Will I need to obtain a claim form to receive services? |
| A) |
For In-Network services, you do not need to obtain a claim form. Simply tell your
provider that you are a TruAssure/EyeMed Vision Care plan member when you make your
appointment or visit a participating provider location. You should present your
TruAssure information card to identify yourself as a TruAssure/EyeMed Vision Care
plan member.
For Out-of-Network services, you may obtain a Vision Claim Form from our website or by calling our toll-free customer care number, 1-866-723-0513. No pre-authorization is required. |
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| Q) | How long do I have to wait to get an appointment with my vision care provider? |
| A) | You should be able to schedule a routine appointment (unless you are requesting a specific time or day of the week) within two to three weeks. Emergency visits should be scheduled within 24 hours. |
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| Q) | Does my plan cover contact lenses? |
| A) | Most TruAssure vision care plans offer a contact lens allowance for fit, follow-up visits and materials that can be used in lieu of the eyeglass lens benefits. |
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| Q) | What is the difference between “visually required” and “cosmetic” contact lenses? |
| A) |
"Visually required” contacts are a covered benefit for members that have one of
four medical conditions:
1. Keratoconus where the patient is not correctable to 20/30 in either or both eyes using standard spectacle lenses. 2. High Ametropia exceeding –12 D or +9 D in spherical equivalent. 3. Anisometropia of 3 D or more. 4. Patients whose vision can be corrected two (2) lines of improvement on the visual acuity chart when compared to best corrected standard spectacle lenses. Most standard contact lens purchases are classified as “cosmetic” or “elective” because the patient has a choice between wearing contacts or wearing glasses. Please note that the allowances for cosmetic or elective contact lenses are different from the allowance for visually required lenses. TruAssure vision care plans offer generous allowances for both types of contact lenses. |
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| Q) | Can I get glasses and contact lenses? |
| A) |
This will vary by your specific plan coverage. In most cases, contact lenses are
in lieu of eyeglass lenses; you can get frames and contacts within the same benefit
period. Please refer to your Certificate of Coverage for specific plan allowances.
Most TruAssure plans will also offer a 40% discount off complete pair eyeglass purchases and a 15% discount off conventional contact lenses in addition to the funded benefit. Please refer to your Certificate of Coverage to see if your plan offers this discount. Additionally, your TruAssure vision care plan provides a discount program at In-Network providers that offers 20% savings on items that are not covered by the plan. There are no claim forms to process and members have unlimited frequency on these purchases. This discount does not apply to professional services or contact lenses. |
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| Q) | Does the plan limit the kind of eyeglass frames I can choose? |
| A) |
To ensure that you are totally satisfied with your benefit, the TruAssure vision
care plan allows members to choose from any available frame at a provider location.
Members may apply their frame allowance to the frame of their choice, and will receive
20% off any remaining balance – equating to significant savings on high quality
eyewear. Most independent providers and all LensCrafters locations carry high quality designer frames by Luxottica, which may include: Anne Klein®, Brooks Brothers®, Persol®, Vogue® and many others. |
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| Q) | What about extras, such as ultraviolet protection, anti-scratch coating and anti-reflective coatings? |
| A) | TruAssure vision care plan members will receive discounts of up to 40 – 50% on the most popular lens options such as ultraviolet, scratch-resistant and anti-reflective coatings, tints, progressive lenses and polycarbonate lenses. Members receive a 20% discount on additional lens options. |
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| Q) | Does your provider list include all types of eye care professionals? |
| A) | Our network of vision care providers includes ophthalmologists (MD/DOs), optometrists (ODs) and opticians (RDOs). All providers are carefully credentialed before they are admitted into our network. |
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| Q) | What is the difference between an ophthalmologist, optometrist and optician? |
| A) |
The TruAssure / EyeMed Vision Care network consists of: |
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| Q) | Can I apply for individual vision care insurance through TruAssure? |
| A) |
Unfortunately, TruAssure only offers group insurance coverage through your employer
or some other qualified organization. If your employer does not offer TruAssure
vision care insurance at this time, ask your Human Resources department to contact
us at 1-800-414-4988 and we will be happy to provide them with information on TruAssure’s
products.
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| This FAQ is intended for general informational purposes only. If you have specific questions regarding benefit coverage, limitations or exclusions contact our customer service department at 1-866-723-0513. | |