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You can easily locate a provider by searching
this website. If you prefer to speak with a Customer Service
representative, please call 1-800-828-9341. |
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1. Simply search
for a provider using this web site or call our customer
 service line at 1-800-828-9341 for
assistance.
2. Schedule an appointment and identify yourself as an Avesis
member.
3. Present your ID card and pay any copay or additional expenses.
To view a online video on how to use your plan
click here. |
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You will receive two ID cards in the mail once
you have enrolled. For a replacement or duplicate card, you
may print one directly from this website. |
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Your benefits can be used as frequently as described
in the benefits description. You may purchase additional items
beyond the plan allowance at a discount. |
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Claim forms and mailing instructions are
available here.
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No. Once eligible for services, you may choose
a provider from the Avesis Provider Directory. When calling
to make an appointment, please let them know that you are a
member of the Avesis plan. They will ask for your member ID
number and then the doctor will verify your eligibility. |
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Members who elect to use a non-participating
provider must pay the provider in full at the time of service
and submit a claim to Avesis for reimbursement. Reimbursement
levels are in accordance with the non-participating reimbursement
schedule listed on your benefit summary. Non-participating benefits
are subject to the same eligibility, availability, frequency
of benefits, and limitation and exclusion provisions of the
plan. |
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You will receive the maximum benefit when you
go to a participating provider. Avesis does offer an out-of-network
benefit. Your reimbursement is based upon your benefit schedule. |
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You have two options:
1) You
may contact Avesis with the name, address and phone
number
of the provider and the Network Development department will
contact
the provider for recruitment.
(OR)
2)
You may pay for your services and submit your itemized statement
to
Avesis
for reimbursement according to the Non-Participating
Reimbursement
Schedule. |
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Your plan is designed to cover eye examinations
and corrective eyewear upon payment of any applicable copayments.
Should you choose options that are not covered within your plan
allowance, a discount will be applied. |
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You may choose from a wide variety of frames
within the provider’s office. You can stay within your
plan allowance and incur no out-of-pocket expenses. Alternatively,
if the wholesale cost of the frame (what the doctor pays the
manufacturer for the frame) exceeds your plan allowance, you
would pay the difference between the cost and the plan allowance.
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Avesis covers standard single vision, bifocal
and trifocal lenses (plastic or glass). If you choose specialty
lenses (e.g., progressive or, hi-index), you will receive a
discounted retail price and an allowance to use toward that
discounted price. |
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Medically Necessary Contacts are required
when a vision care provider has determined that spectacle
lenses and frames would not achieve the best vision correction
possible due to a medical condition.
In most cases diagnosis such as:
• Keratoconus
• Corneal trauma
• Post cataract surgery
• Anisometropia
will qualify a member for medically
necessary contacts.
Prior approval is required for services. |
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No. The Avesis plan does not cover medical
or surgical treatment for eye disease or eye injury. You should
contact your health plan for assistance in locating an appropriate
medical vision provider. If you have a medical emergency, call
911 right away or go to the nearest hospital emergency room.
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Yes. It is not necessary to have your ID card
to receive services from an Avesis participating provider.
When you make your appointment with the provider and identify
yourself as an Avesis member, the provider will contact us
to verify what services you are eligible to receive. |
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Please call our Customer Service department
at 1-800-828-9341. When you call, please identify yourself as
an Avesis member. The Customer Service department office
hours are as follows: Hours
M- F: 7am - 5pm (MST)*
*During daylight savings time use (PST) |
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