Vision Coverage from EyeMed

EyeMed Vision Care is Zebra’s vision plan provider. With EyeMed, you have access to a large provider network. The vision plan provides coverage for eye exams, lenses and frame allowances according to the following frequency limits:

Coverage

Frequency

Eye Exams

One exam every calendar year

Lenses or Contact Lenses

One pair every calendar year

Frame

One pair every calendar year

You pay less out of pocket when you use an EyeMed provider, such as:

  • LensCrafters
  • Pearle Vision
  • Target Optical
  • Private Practitioners

You receive enhanced benefits when you visit a PLUS Provider in the EyeMed network.  Members who visit a PLUS Provider will receive:

  • Free eye exams (does not include contact lens exam)
  • An additional $50 frame allowance, bringing the total frame allowance up to $200

There are more than 4,000 PLUS Providers nationwide, including independent vision providers and retail and online stores. You can find PLUS Providers in the EyeMed provider directory by looking for the PLUS symbol.

If you choose an out-of-network provider, your benefit is based on a reimbursement schedule.

Vision Care Service

In-Network Member Cost

Out-of-Network Reimbursement

Exam with dilation as necessary

$10 copay

Up to $50

Contact lens fit and follow-up (contact lens fit and two follow up visits once a comprehensive eye exam has been completed)

Standard contact lens fit and follow-up

Up to $55

N/A

Premium contact lens fit and follow-up

10% off retail

N/A

Frames

$0 copay; $150 allowance; 20% of charge over $150

Up to $70

Standard plastic lenses

Single vision

$15 copay

Up to $50

Bifocal

$15 copay

Up to $75

Trifocal

$15 copay

Up to $100

Lenticular

$15 copay

Up to $125

Standard progressive lens

$80

Up to $75

Premium progressive lens (add-on to bifocal) – Tier 1 – Tier 3

$100 – $125

Up to $75

Premium progressive lens (add-on to bifocal) – Tier 4

$80, 80% of charge less than $120

Up to $75

Lens options (paid by the member and added to the base price of the lens)

UV treatment, tint (solid and gradient)

$15 Copay

N/A

Standard plastic scratch coating

$0 Copay

N/A

Standard polycarbonate (adults)

$40

Up to $5

Standard polycarbonate (children under age 19)

$0 Copay

N/A

Standard anti-reflective coating)

$45

Up to $5

Polarized

20% off retail price

N/A

Photochromic/transitions

$75

N/A

Premium anti-reflective coating – Tier 1/Tier 2

$57/$68

N/A

Premium anti-reflective coating – Tier 3

80% of charge

N/A

Other add-ons

20% off retail price

N/A

Contact lenses

Conventional

$0 copay; $120 allowance; 15% off retail price over $120

Up to $105

Disposable

$0 copay; $120 allowance; plus balance over $120

Up to $105

Medically necessary

$0 copay, paid in full

Up to $210

Laser vision correction

15% off retail price OR 5% off promotional pricing through U.S. Laser Network. Call 1-877-552-7376 to locate a provider

N/A

Other add-ons and services

20% off retail price

N/A

ID Cards

If you are enrolling in the Zebra vision plan for the first time, you will receive a new vision ID card mailed to your home.