Members

How-to Questions

• How do I find a Provider?

  If you are an Avēsis member, please log in and click the Search for Providers option. The Provider Finder will display a full list of all conveniently located providers participating in your plan. Since some providers don't participate in all of our plans, logging in will give you the most accurate list.

• How do I get an ID card?

  If you are in need of vision care services and your Avēsis ID Card has not yet arrived in the mail, you can print off a temporary ID card. Simply log in as a member, select "Print ID Card," and print!

• How can I use my benefits?

  Your Avēsis vision care benefits are outlined in your group’s Summary Plan Booklet. At any time, additional items beyond the covered plan allowance are available to you at a substantial discount.

• How do I submit a claim for reimbursement to Avēsis?

  If you use an in-network provider, you never have to file a claim. Members who choose out-of-network providers are responsible for making full payment at the time of service. For reimbursement up to plan allowances, fill out the form found here, and mail it with your detailed receipt for services to:
  
  Avēsis Third Party Administrators, Inc.
  Claims Department
  P.O. Box 38300
  Phoenix, AZ 85069-8300

Provider-Related Questions

• Do I have to select a doctor when I sign up for a vision care plan?

  No. Once you are eligible for the plan's covered services, simply select a provider from our Provider Directory. When you make an appointment, please let the provider's office know that you are a member of the Avēsis program. You'll need only your name and member ID; they'll take care of the rest!

• What is the difference between participating provider benefits and non-participating provider benefits?

  You’ll save a great deal more when electing a provider who participates in the Avēsis program. But we want you to enjoy the flexibility to choose any provider you like. When visiting an out-of-network provider, you’ll pay in full at the time of service, then submit a claim to us for reimbursement up to your covered amounts. (See your benefit summary for details). Click here for a claim form. Fill it out and mail it with your detailed receipt for services to:

  
  

  Avēsis Third Party Administrators, Inc.
  Claims Department
  P.O. Box 38300
  Phoenix, AZ 85069-8300

• Can I go to any provider?

  Absolutely! The Avēsis vision care program gives you the freedom to choose a provider you like at the office you prefer. You’ll get the maximum financial benefit when you use a participating provider; however, we offer some out-of-network benefits depending upon your plan. Reimbursement is based upon your group’s benefit schedule.

Plan Questions

• What is covered in the plan?

  Most Avēsis plans are comprehensive and include eye examinations and corrective eyewear upon payment of any applicable copayments. Copay amounts and other details vary, so check your exact benefits by logging in. Should you choose options that are not covered within your plan allowance, simply pay the difference at the time of service.

• What type of frames does Avēsis cover?

  You may choose any frame in your provider’s inventory or on the market today! If you stay within your plan allowance, you’ll incur no out-of-pocket expenses. If you exceed your plan allowance, you’ll still get that frame at a discount.
  
  Avēsis is not owned by, not do we own retail optical outlets, optical labs, or frame or lens manufacturers, so we have no vested interest in your selection. Our singular focus is on providing the best essential vision care benefits available.

• What types of spectacle lenses are covered?

  Avēsis covers standard single-vision, bifocal, and trifocal lenses in plastic or glass. Specialty lenses — progressive, photo-chromatic, high-index, etc.— are available to members at a uniform discounted price. Your allowance is equal to the plan payment for standard lenses, and you'll pay only the difference between the allowance and the discounted price, resulting in substantial savings for you.

  
  
  

  You'll save on lens coatings—tints, anti reflective, and scratch-resistant coatingsetc,— too, available at the uniform discounted price.

  
  
  

  Avēsis leaves the judgment for your eyewear needs where it belongs: with your provider, who will ensure optimal optic correction and fit.

• What are medically necessary contacts?

  When a vision care provider has determined that spectacle lenses and frames will not achieve the best vision correction possible due to a medical condition, those contact lenses are deemed medically necessary. In most cases, the following diagnoses will qualify a member for medically necessary contacts (prior approval is required):

  • Keratoconus
  • Corneal trauma
  • Post-cataract surgery
  • Anisometropia

• If I need medical or surgical treatments for eye disease or any eye injury, should I go to an Avēsis provider?

  No. Your major medical plan will usually cover eye disease or injury. The Avēsis plan covers primary vision care. If you need help locating an appropriate medical vision provider, please contact your health plan's customer service department. If you have a medical emergency, call 911 or go to the nearest hospital emergency room.

• Can I receive vision care services from an Avēsis participating provider without an ID card?

  Yes! You need only your name and date of birth when scheduling your appointment. Tell the provider’s office that you’re an Avēsis plan member, and they'll do the rest.

• If I have questions about my Avēsis plan, whom should I call?

  We strive to exceed your expectations. Please visit our Contact Us page to submit an inquiry or find out information on how to contact us.
  Click here to Contact Us