• What vision services are covered under my Vision Care plan?
• How does Vision Care coverage work?
• What are the advantages of using in-network vision providers?
• How do I find an in-network provider?
• Does Vision Care cover Lasik?
• Will I get a separate member ID card for Vision Care?
• What if I have questions about my vision coverage?
What vision services are covered under my Vision Care plan?
Vision Care coverage provides benefits for eye exams, a wide range of name brand and fashion frames and lenses, many different contact lens options, and discounts on laser vision correction. Depending on the Vision Care plan your employer chooses – Premier or Preferred – you will make copayments or receive discounts off these services. Also, these services may be available to you once every 12 or 24 months, or the frequency may be unlimited. For benefit details, check your Vision Care Rider. Your Vision Care benefits are provided through a contractual agreement with Davis Vision*. If you are planning to obtain services under Vision Care and want the services to be covered at the highest benefit level, you need to select a participating vision provider who is contracted with the Davis Vision Network.
Please note that benefits with your Vision Care Rider are separate and in addition to any vision coverage that is offered by your Blue Cross and Blue Shield of New Mexico (BCBSNM) medical plan. For example, your medical plan covers vision screening for members through age 17, and it covers disease or injury to the eye for members of any age. Your medical plan also provides for certain vision-related services for diabetic members. For vision services covered by your medical plan, you need to follow the medical plan guidelines and use the participating providers for your specific plan (e.g., PPO, HMO, etc.). For more information, see your medical plan Benefit Booklet or call Customer Service using the phone number on the back of your member ID card.
How does Vision Care coverage work?
You make an appointment with the provider of your choice. At the doctor's office, present your BCBSNM member ID card. You will pay a copayment for a vision exam from an in-network provider. For a vision exam from an out-of-network provider, you will pay a portion and your Vision Care Plan will pay the rest. Out-of-network providers may request payment in full at time of service; you will need to submit a claim to Davis Vision for reimbursement. See your Summary of Benefits for the amounts you pay.
For glasses (frames and spectacle lenses), you'll receive a discount off the retail price under the Preferred Plan; you will be responsible for copayment(s) for spectacle lenses and frames under the Premier Plan. For contact lenses, you will pay a percentage off the retail cost depending on your plan. Some services or types of materials are not covered if they are received from an out-of-network provider. See your Vision Care Rider for more information.
What are the advantages of using in-network vision providers?
Davis Vision has over 20,000 providers nationwide. The network includes EyeMasters® and many independent ophthalmologists, optometrists, and opticians. You will have greater coverage and pay less out of your pocket when you use Davis Vision providers. For most services, you will pay a copayment or pay the discounted amount for services or materials. If you use an out-of-network provider, some of the services are not covered. For covered services from an out-of-network provider, you will need to pay the full amount out of your pocket and file a claim with Davis Vision for reimbursement of the covered amount. Note: To ensure your vision services are covered, it is important to ask if your provider participates with the Davis Vision network and let them know you are a BCBSNM member.
How do I find an in-network provider?
Search the Provider Finder for an in-network Davis Vision provider. You may also call Davis Vision toll-free at 1-877-393-2393 to find participating providers.
Yes, your Vision Care plans provide a discount off the retail cost of Lasik or PRK. There is no coverage for Lasik if received from an out-of-network provider. To find a participating Lasik provider, call 1-877-393-2393.
Will I get a separate member ID card for Vision Care?
No. Simply use the member ID card issued for your BCBSNM medical plan. Your vision provider will need the identification number on your member ID card and can contact Davis Vision to verify eligibility and benefits on your behalf.
What if I have questions about my vision coverage?
For more information about covered vision services, in-network providers, or benefits, call the vision claims administrator (Davis Vision) toll-free at 1-877-393-2393 Monday through Friday 6 a.m. to 9 p.m., Saturday 7 a.m. to 2 p.m., and Sunday 10 a.m. to 2 p.m. Mountain Time.
For information on your health care benefits, enrollment, termination, and eligibility questions, call the Customer Service number on the back of your member ID card.
*Blue Cross and Blue Shield of New Mexico vision coverage is administered through a contractual agreement with Davis Vision. The relationship between Blue Cross and Blue Shield of New Mexico and Davis Vision is solely that of independent contractors.
