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Eyemed medically necessary contacts 2025

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The document is a claim form for medically necessary contact lenses from EyeMed, detailing the required patient and subscriber information, reimbursement codes, and guidelines for submitting claims. It outlines specific conditions eligible for reimbursement, including anisometropia, high ametropia, keratoconus, and vision improvement, along with associated reimbursement amounts. The document emphasizes the importance of accurate submissions to avoid disciplinary actions and provides instructions for faxing claims.

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What makes contact lenses medically necessary?

Conditions such as keratoconus, dry eye syndrome, corneal scarring, and irregular astigmatism will qualify for medically necessary contact lens benefits. What insurance covers medically necessary contact lenses? Vision plans such as VSP (Vision Service Plan), EyeMed, and Spectera have this benefit.

What does VSP consider medically necessary contacts?

Necessary Contact Lenses: Covered in full less applicable copays, when prescribed by a VSP doctor for one of the following conditions: following cataract surgery; to correct extreme vision problems that cannot be corrected with prescription glasses; with certain conditions of anisometropia; or with certain conditions

What is considered medically necessary for contact lenses?

Medically Necessary Conditions Conditions in which eyeglasses are contraindicated and/or contacts lenses provide significant improvement in visual acuity and better functional vision for the patient. Necessary because chronic pathology or deformity of the nose, skin or ears precludes the wearing of eyeglasses.

What vision insurance covers medically necessary contacts?

Contact lenses help people with the following types of refractive errors: Nearsightedness (myopia). Farsightedness (hyperopia). Age-related farsightedness (presbyopia). Astigmatism.

What does EyeMed consider a premium contact lens fitting?

**Premium Contact Lens Fitting-all lens designs, materials and specialty fittings other than Standard Contact Lenses (examples include toric, multifocal etc.) ***Standard Polycarbonate available at no charge to dependents

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