Using your Medicare vision benefits

Vision services included in your plan

Your Priority Health vision coverage is administered by EyeMedSM. Routine vision services covered by your plans include:

  • $0 for one routine exam each year (includes dilation and refraction)
  • $0 for one retinal imaging per year
  • $100-$200 eyewear allowance per year, depending on plan

See the Appendix in your Evidence of Coverage document for details.

Optional Enhanced Vision services

In addition to the vision coverage included in your medical plan, the enhanced dental and vision package also includes $150 additional allowance for eyewear each year.

See the Appendix in your Evidence of Coverage document for details.

Find an EyeMed network provider

As a Priority Health EyeMed member you have access to thousands of independent providers as well as national retailers such as LensCrafters, Pearle Vision and Target Optical.

Routine vision services must be provided by an EyeMed "Select" provider. Call 844.366.5127 (TTY 711), Monday through Friday from 8 a.m. to 8 p.m. Or search here.

When you go to an EyeMed "Select" network provider, they file your claim and you only have to pay the cost of any services or eyewear that exceeds your plan's benefit. Show your Priority Health Medicare member ID card to health care providers when using your vision benefits.

How to seek reimbursement when you use a non-EyeMed "Select" network provider

If you use a non-EyeMed “Select” provider (out-of-network provider) you will be responsible for paying the cost of any expense out-of-pocket. You are eligible to submit for reimbursement for covered services, see the list below for reimbursement amounts. To seek reimbursement, please submit an EyeMed out-of-network claim form or required claim information with an itemized receipt with your name included.

Eligible reimbursement amounts:

  • Up to $50 reimbursement for one routine exam each year (includes dilation and refraction)
  • Up to $20 reimbursement  for one retinal imaging per year
  • $100-$200 eyewear allowance reimbursement per year

Note: You may choose to use benefits in-network with an EyeMed “Select” provider OR see a Non-EyeMed “Select” network provider (out-of-network provider) and seek reimbursement. Allowances/benefits or reimbursement are offered once per year per benefit. In-network and out-of-network benefit cannot be combined.

You can request an out-of-network claim form be mailed to you by calling the EyeMed Customer Service Department at 844.366.5127, Monday through Friday 8 a.m. to 8 p.m. EST (TTY users should call 711).

Not enrolled in the Enhanced Dental and Vision package yet? 

To see the full EyeMed Certificate of Coverage please reference the Vision Appendix in your Evidence of Coverage.