Frequently Asked Questions
How to Questions
How do I find an in-network provider?
You can easily locate a provider by going to the Provider Search tab. If you prefer to speak with a Customer Service representative, please call 1-800-828-9341.
How do I use the plan?
- Simply search for a provider using this web site or call our customer service line at 1-800-828-9341 for assistance.
- Schedule an appointment and identify yourself as an Avesis member.
- Pay any copays or additional expenses.
To view an online video on how to use your plan click here.
How often can I use my benefits?
Your benefits can be used as frequently as described in the benefits summary. You may purchase additional items beyond the plan allowance at a discount at a participating provider.
After I use my benefits, when will I be able to get services again?
Your exam, lenses, and contact lens benefits will reset 12 months from the date of service. Your frame benefit will reset after 24 months from the date of service.
How do I submit a claim for reimbursement to Avesis?
Claim forms and mailing instructions are available here.
How do I sign-up?
Click Here to Sign up
When does my plan start?
You are eligible to receive services on the first day of the first month after you sign-up and your credit card is billed for your first month's premium is collected.
Do I have to select a provider when I sign up for the vision care plan?
No. Once eligible for services, you may choose a provider from the Avesis Provider Directory or any other provider of your choice. 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 provider will verify your eligibility.
What is the difference between participating provider benefits and non-participating provider benefits?
Members who elect to use a non-participating provider must pay the provider in full at the time of service and submit a claim 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.
Can I go to any provider?
Yes, you will receive maximum benefits when you go to a participating Avesis provider. The plan does offer out-of-network benefits. Your reimbursement is based upon your benefit schedule.
If my provider is not on the Avesis directory and I still want to go to him/her for my vision services, what can I do?
You have two options:
- 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. Click here to nominate a provider.
- You may pay for your services and submit your itemized statement to Avesis for reimbursement according to the Non-Participating Reimbursement Schedule.
What is covered?
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, a discount will be applied, at a particpating provider.
What type of frames are covered through my plan?
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 you select a frame with a wholesale cost (what the provider pays the manufacturer for the frame) that exceeds your plan allowance, your plan allowance will be applied and a discount of 10% to 40 % will apply to any remaining balance.
What type of spectacle lenses are covered?
The plan covers standard single vision, bifocal and trifocal lenses (plastic or glass). If you choose specialty lenses (e.g., progressive), you will receive a discounted retail price and an allowance to use toward that discounted price.
What are medically necessary contacts?
Medically Necessary Contacts are 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:
- Corneal trauma
- Post cataract surgery
will qualify you for medically necessary contacts. Prior approval is required for services.
If I need medical or surgical treatment for eye disease or an eye injury, does my plan provide coverage?
No. The Avesis plan does not cover medical or surgical treatment for eye disease or eye injury. We recommend, contacting 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.
Can I receive vision care services from an Avesis participating provider without an ID card?
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.
If I have questions about my Avesis care plan, whom should I call?
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: 7:00am - 8:00pm EST, Monday - Friday
What forms of payment are accepted?
Through this website you can enroll into the vision plan and select one of four payment methods
- Major credit card (Visa, Mastercard, American Express, Discover)
- Bank Draft (Checking or Savings)
- Debit Card
- PayPal (view a video)
Once enrolled, when will my account be charged?
Your account will be charged upon intial enrollment. The date of the intial enrollment will dictate the day of the month for all future reoccuring payments. If the intial enrollment falls on the 31st, the billing cycle will be adjusted to the first of the following month. If the intial enrollment falls on the 29th or 30th, the next billing would occur on the 1st. Please note: only one payment will be collected within a 30 day time frame.
What will appear on my Statement?
Each month your premium will be deducted from your credit card or bank account. The amount charged will be the amount associated with your selection during enrollment. Charges will appear as FB VISION.
How do I change or update my payment information?
For expiring credit cards, new banking information or transfers, contact an Avesis Representative for assistance 1-800-828-9341.