Frequently Asked Questions

How do I use my benefits?

Using your Opticare benefits is easy. Just locate a provider on www.opticarevisionservices or and schedule your eye exam. Remember to identify yourself as an Opticare member. You don’t even need your Opticare card when you arrive at your appointment, every provider can look you up with just your name and date of birth.

What are my benefits?

You will receive a summary plan design when you enroll that will explain simply what your allowances and co-pays, you can also ask your HR department, call Opticare Member services at 1-800-363-0950, login to the Member Gateway Portal on our website or download the MyOpticare App on ITunes or GooglePlay.

How do I file a claim?

When you visit an in-network provider you will not need to file a claim. The provider takes care of all of that for you. If you visit a provider that is not in network you can download and claim form on to fill out online or print and mail to us. Note: not all plans have out of network benefits so please check your plan design documents.

How often can I use benefits?

Most Opticare plans have an annual eye exam benefit as well as annual frame, lens and contact lens benefits. Some plans have a frame benefit offering every 2 years so check your plan outline to make sure.

How do I schedule my eye exam?

  1. Click on our website: and click on LOCATE PROVIDER from the menu.
  2. Call 385-270-8200
  3. Or schedule in real time: and click SCHEDULE EYE EXAM

Can I use benefits for contacts?

Certainly. Every plan has a contact lens allowance that can be used annually in lieu of the eyeglass benefit. This means if you use your benefits on contacts you cannot use the frame and lens benefit in the same plan year.

Can I use my benefits on LASIK?

Yes. Every Opticare plan has a rich refractive surgery benefit through Standard Optical. Their state-of-the-art LASIK Surgery Center is located in Holladay, Utah and has performed over 25,000 LASIK procedures. Call 801-272-8861 to schedule a free consultation or visit our website for more info.

Can I go to Costco or other Out of network providers?

If you visit a provider that is not in network you can download and claim form on to fill out online or print and mail to us. Note: not all plans have out of network benefits so please check your plan design documents.

I don’t need glasses, should I get an exam?

Eye exams test for many more things than just your refractive error (prescription). A comprehensive eye exam can diagnose diabetes, hypertension, heart disease, immunodeficiencies such as lupus, sight threatening conditions like glaucoma and macular degeneration and other potentially serious health conditions like migraines, brain tumors, cancer and more. See our research paper on our website for more detailed info as well as the recommended eye exam intervals for people that don’t require glasses.

Opticare Vision Services

How much does Opticare save me?

The average Opticare member saves 72% on glasses compared to retail pricing. This is a significant dollar savings, on average, of over $350.

Can I use benefits on sunglasses?

Opticare covers prescription and nonprescription sunglasses with the regular frame and lens benefit.

How can I check eligibility, dependent info, claim status, etc?

Register and login to the Member Gateway Portal on www.opticarevisionservices .com, download the MyOpticare App or call member services at 1-800-363-0950.

Can I keep my Opticare plan if I lose my job?

If you’ve recently lost your job, you may be eligible to continue your health insurance, including your Opticare plan for up to 18 months with COBRA. Coverage will continue to apply to family members and dependents who were originally covered under your plan. If you enroll in COBRA, you’ll continue to have the same great coverage, but will have to pay the full premium of the plan, plus an administrative fee. You can compare the cost of COBRA against other health plans to see which options work best for you. To learn more about COBRA, visit https:// topic/health-plans/cobra.

Eye Care is Health Care

How often should I get an eye exam?

An eye exam is recommended every year.Caring for your eyes should always be a part of your regular healthcare routine and as a rule, you shouldn’t go longer than two years between eye exams. You may need to have your eyes examined more often if you have a family history of eye diseases, diabetes, have general poor health, or you’re taking medications that may have potential side effects on the eye. An eye exam can also help your doctor see signs of common health conditions like high cholesterol, high blood pressure, glaucoma and diabetes.

Can I use my FSA/HSA?

Absolutely. Medical savings accounts are a great way to pay for co-payments, non-covered upgrades or extras. All licensed Optometry providers are approved for savings account spending.

What if I lose my card?

We will mail each primary policy holder 2 cards. If you lose them you can print a card on demand through the Member Gateway Portal on our website, use the MyOpticare App to access a card or call our member services team at: 1-800-363-0950.

What is my deductible or Outof-Pocket Expenses:

Opticare plans do not have a deductible and most items are covered by a co-pay. Any additional items not covered would be an out of pocket expense. Here are some examples of possible out-ofpocket expenses and co-pays:

  • Scratch-resistant coating
  • Anti-reflective coating
  • Ultraviolet (UV) protection
  • Progressive (no-line) lenses
  • Specialty bifocal lenses
  • Photochromic (Transitions) lenses

What Is the waiting period?

There is no waiting period for benefits. You will be eligible on the first of the month after your group or individual enrollment active or renewal date. You are subject to your employer benefits eligibility and probationary periods, so please check with your HR department regarding your benefit eligibility.