EmblemHealth Vision Services Program

Date Issued: 1/6/2017

Effective January 1, 2017, EmblemHealth is pleased to announce we have partnered with EyeMed Vision Care IPA, LLC (“EyeMed”) to manage all member vision benefits.

EyeMed will administer all routine exams (to determine if corrective lenses are required) and the dispensing of hardware such as frames, lenses and contact lenses based on the member’s benefit. EyeMed is responsible for the provider network including contracting and credentialing, claims processing and payment, routine vision grievances and claims appeals.*

*Exception: Medicare grievances and claim appeals will continue to be managed by EmblemHealth.

Affected Membership
EyeMed is the vision services provider for all EmblemHealth members with a vision care benefit. This includes ASO members whose vision benefit is managed by EmblemHealth. Please note not every EmblemHealth member has a routine vision benefit.

Members with the Montefiore, HealthCare Partners or AdvantageCare Physicians logo on their ID card are also included in this program and should be directed to use an EyeMed vision provider.

Finding a Participating EyeMed Vision Provider
If your patients previously got their vision benefits from Davis Vision (a.k.a.VisionWorks), GVS, EyeCare Advantage or an independent in-network provider, starting January 1, 2017, they must use an in-network EyeMed provider in order to get covered benefits (in accordance with their benefit plan.)

For help finding an in-network EyeMed provider, and to ask about benefits, please share the following EyeMed Customer Service toll-free numbers with your patients:

1-844-790-3878 Medicare
1-877-324-2791 Medicaid
1-877-324-4063 Commercial (HMO, PPO, POS)
1-877-324-6211 On/Off Individual and Group Exchange
and Essential Plans

Participation with EyeMed
Vision providers interested in joining the EyeMed network can complete an online interest form found at forms-engine.com/eyemed/NewProvider-Direct.html or call EyeMed’s provider service department at 1-800-521-3605. In-network EyeMed providers can be found using EyeMed’s Provider Locator tool.