Eye vision claim: Fill out & sign online

Here's how it works

01. Edit your eyemed reimbursement form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send eye med vision claim via email, link, or fax. You can also download it, export it or print it out.

How to edit Eye med claim form online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your paperwork requires just a few simple clicks. Follow these quick steps to edit the PDF Eye med claim form online free of charge:

Sign up and log in to your account. Sign in to the editor with your credentials or click Create free account to evaluate the tool’s capabilities.
Add the Eye med claim form for redacting. Click the New Document button above, then drag and drop the sample to the upload area, import it from the cloud, or using a link.
Adjust your template. Make any changes required: add text and photos to your Eye med claim form, underline important details, remove sections of content and replace them with new ones, and insert icons, checkmarks, and areas for filling out.
Finish redacting the form. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is very user-friendly and effective. Try it now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Contact us

Does EyeMed do reimbursements?

You must submit a claim form to EyeMed for reimbursement.

Does EyeMed reimburse Costco?

If you use a Costco, Wal-Mart or other non-network provider, you will need to pay the entire bill at the time services are provided and submit a completed claim form to EyeMed Vision Care. For services at all Costco and Wal-Mart optical locations, youll receive reimbursements equivalent to in-network benefits.

Is EyeMed the same as Cigna?

All Cigna Vision products and services sold on or after September 1, 2022 are provided exclusively by or through EyeMed Vision Care. More access.

Can you use EyeMed at Costco?

If you use a Costco, Wal-Mart or other non-network provider, you will need to pay the entire bill at the time services are provided and submit a completed claim form to EyeMed Vision Care. For services at all Costco and Wal-Mart optical locations, youll receive reimbursements equivalent to in-network benefits.

How do I get a refund from EyeMed?

You can now submit your form online or by mail. Dont wait to submit your claim - forms must typically be submitted within 15 months of the date of service to receive reimbursement*. To access the out-of-network form or to check the status of a claim, log in to your Member Web account and navigate to the Claims tab.

Related forms

be ready to get more