How to use your vision benefits for glasses and contacts
Step-by-step on scheduling an exam, picking frames, and maximizing your vision allowance — including out-of-network reimbursement.
Using your vision benefits is mostly about knowing the schedule (when each piece resets) and using in-network providers. The exam, frames, and lenses are usually three separate benefits with their own reset dates.
Before you book
- Check your eligibility dates — Log into the vision plan's portal to see when each benefit (exam, lenses, frames) last reset.
- Have your member ID handy.
- Note your frame allowance dollar amount.
In-network workflow
- Find an in-network provider
Use your vision plan's provider locator. Most major retail chains and many independent optometrists participate.
- Book the routine exam
You'll typically pay a $10–$25 copay at the visit. The plan settles directly with the provider.
- Pick frames within your allowance
Anything over the allowance comes out of pocket. Many plans give an additional 20% off the overage if you're at an in-network store.
- Choose lens material and coatings
Basic single-vision lenses are usually fully covered. Progressives, anti-reflective coating, and photochromic lenses are typically extra — ask for a price sheet before agreeing.
- If you want contacts instead
Tell the optometrist before the exam — contact lens fittings are a separate evaluation, sometimes with an extra copay. Most plans require you to choose glasses OR contacts in the same period.
Out-of-network reimbursement
- Pay in full at the time of service
Most out-of-network providers won't bill the plan directly. You'll pay the full price upfront.
- Save the itemized receipt
It must show the prescription, the date, and a breakdown of exam, frame, and lens costs.
- Submit a claim form
Download your plan's out-of-network claim form. Fill it out, attach the receipt, and submit by mail, fax, or upload.
- Wait 4–6 weeks for the check
Out-of-network reimbursement is usually a fraction of the in-network value — for example, $35 for an exam or $45 for a frame.
FAQ
- Can I use my FSA or HSA on top of vision insurance?
Yes. Anything you pay out of pocket — copays, frame overages, contact lenses — is an eligible FSA and HSA expense.
- Do prescription sunglasses count toward the frame allowance?
Yes, but you can usually only use the frame allowance once per benefit period — so it's regular glasses OR prescription sunglasses, not both.
- What if my prescription changes during the year?
Most plans only cover one set of lenses per benefit period regardless of prescription changes. Some plans have a 'second pair discount' that gives you 20–30% off another pair.