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Vision Plan (Low Plan & High Plan)
EyeMed
EyeMed vision plans for Tarrant County Hospital District offered on the Insight network, with two tiers: a Low Plan and a High Plan. Both plans cover exams, frames, lenses, and contact lenses with in-network co-pays and out-of-network reimbursements; the High Plan provides twice-per-plan-year frequency for frames, lenses, and contacts versus once-per-plan-year or every-other-year for the Low Plan.
Vision: Low Plan vs High
The High Plan provides frames twice per plan year versus every other plan year on the Low Plan — members get frames twice as frequently · The High Plan covers lenses twice per plan year versus once per plan year on the Low Plan
| Feature | Low Plan | High Plan |
|---|---|---|
| Network | Insight network | Insight network |
| Exam Frequency | Once every plan year | Once every plan year |
| Frame Frequency | Every other plan year | Twice every plan year |
| Lens Frequency | Once every plan year | Twice every plan year |
| Contact Lens Frequency | Once every plan year | Twice every plan year |
| Exam - In-Network Cost | $10 co-pay | $10 co-pay |
| Exam - Out-of-Network Reimbursement | Up to $40 | Up to $40 |
| Frame - In-Network Cost | $0 co-pay; 20% off balance over $150 allowance | $0 co-pay; 20% off balance over $150 allowance |
| Frame - Out-of-Network Reimbursement | Up to $75 | Up to $75 |
| Single Vision Lens - In-Network Cost | $25 co-pay | $25 co-pay |
| Single Vision Lens - Out-of-Network Reimbursement | Up to $30 | Up to $30 |
| Contacts - Conventional (In-Network) | $0 co-pay; 15% off balance over $150 allowance | $0 co-pay; 15% off balance over $150 allowance |
| Contacts - Disposable (In-Network) | $0 co-pay; 100% of balance over $150 allowance | $0 co-pay; 100% of balance over $150 allowance |
| Contacts - Medically Necessary (In-Network) | $0 co-pay; paid-in-full | $0 co-pay; paid-in-full |
| Additional Pair Discount (In-Network) | 40% off additional complete pair of prescription eyeglasses | 40% off additional complete pair of prescription eyeglasses |
| Non-Covered Items Discount (In-Network) | 20% off non-prescription sunglasses and non-covered items | 20% off non-prescription sunglasses and non-covered items |
Vision Plan Premiums (biweekly)
| Service | Low Plan | High Plan |
|---|---|---|
| Team Member Only | $2.18 | $6.12 |
| Team Member + Spouse | $3.40 | $9.55 |
| Team Member + Children | $3.48 | $9.76 |
| Team Member + Family | $5.59 | $15.74 |
Low Plan Schedule of Benefits (Insight Network)
Exam Services
Exam
Once every plan year
In-Network
- In-Network Member Cost
- $10 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $40
Retinal Imaging
In-Network
- In-Network Member Cost
- Up to $39
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Contact Lens Fit and Follow-Up
Fit and Follow-Up - Standard
In-Network
- In-Network Member Cost
- Up to $40; contact lens fit and two follow-up visits
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Fit and Follow-Up - Premium
In-Network
- In-Network Member Cost
- 10% off retail price
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Frame
Frame
Every other plan year
In-Network
- In-Network Member Cost
- $0 co-pay; 20% off balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Standard Plastic Lenses
Single Vision
Once every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $30
Bifocal
Once every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Trifocal/Lenticular
Once every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $70
Progressive - Standard
Once every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Progressive - Premium Tier 1 - 4
Once every plan year
In-Network
- In-Network Member Cost
- $110 - $240
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Lens Options
Anti Reflective Coating - Standard
In-Network
- In-Network Member Cost
- $45 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $23
Anti Reflective Coating - Premium Tier 1 - 3
In-Network
- In-Network Member Cost
- $57 - $100
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $23
Photochromic - Non-Glass
In-Network
- In-Network Member Cost
- $75
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Polycarbonate - Standard
In-Network
- In-Network Member Cost
- $40
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Polycarbonate - Standard (< 19 years of age)
Children under 19 years of age
In-Network
- In-Network Member Cost
- $0 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $20
Scratch Coating
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Tint
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
UV Treatment
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
All Other Lens Options
In-Network
- In-Network Member Cost
- 20% off retail price
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Contact Lenses
Contacts - Conventional
Once every plan year; instead of glasses
In-Network
- In-Network Member Cost
- $0 co-pay; 15% off balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Contacts - Disposable
Once every plan year; instead of glasses
In-Network
- In-Network Member Cost
- $0 co-pay; 100% of balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Contacts - Medically Necessary
Once every plan year
In-Network
- In-Network Member Cost
- $0 co-pay; paid-in-full
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $300
Other
Hearing Care from Amplifon Network
In-Network
- In-Network Member Cost
- Discounts on hearing aids; call 1-877-203-0675
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Lasik or PRK from U.S. Laser Network
In-Network
- In-Network Member Cost
- 15% off retail or 5% off promo price; call 1-800-988-4221
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
High Plan Schedule of Benefits (Insight Network)
Exam Services
Exam
Once every plan year
In-Network
- In-Network Member Cost
- $10 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $40
Retinal Imaging
In-Network
- In-Network Member Cost
- Up to $39
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Contact Lens Fit and Follow-Up
Fit and Follow-Up - Standard
In-Network
- In-Network Member Cost
- Up to $40; contact lens fit and two follow-up visits
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Fit and Follow-Up - Premium
In-Network
- In-Network Member Cost
- 10% off retail price
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Frame
Frame
Twice every plan year
In-Network
- In-Network Member Cost
- $0 co-pay; 20% off balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Standard Plastic Lenses
Single Vision
Twice every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $30
Bifocal
Twice every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Trifocal/Lenticular
Twice every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $70
Progressive - Standard
Twice every plan year
In-Network
- In-Network Member Cost
- $25 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Progressive - Premium Tier 1 - 4
Twice every plan year
In-Network
- In-Network Member Cost
- $110 - $240
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $50
Lens Options
Anti Reflective Coating - Standard
In-Network
- In-Network Member Cost
- $45 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $23
Anti Reflective Coating - Premium Tier 1 - 3
In-Network
- In-Network Member Cost
- $57 - $100
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $23
Photochromic - Non-Glass
In-Network
- In-Network Member Cost
- $75
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Polycarbonate - Standard
In-Network
- In-Network Member Cost
- $40
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Polycarbonate - Standard (< 19 years of age)
Children under 19 years of age
In-Network
- In-Network Member Cost
- $0 co-pay
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $20
Scratch Coating
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Tint
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
UV Treatment
In-Network
- In-Network Member Cost
- $15
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
All Other Lens Options
In-Network
- In-Network Member Cost
- 20% off retail price
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Contact Lenses
Contacts - Conventional
Twice every plan year; instead of glasses
In-Network
- In-Network Member Cost
- $0 co-pay; 15% off balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Contacts - Disposable
Twice every plan year; instead of glasses
In-Network
- In-Network Member Cost
- $0 co-pay; 100% of balance over $150 allowance
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $75
Contacts - Medically Necessary
Twice every plan year
In-Network
- In-Network Member Cost
- $0 co-pay; paid-in-full
Out-of-Network
- Out-of-Network Member Reimbursement
- Up to $300
Other
Hearing Care from Amplifon Network
In-Network
- In-Network Member Cost
- Discounts on hearing aids; call 1-877-203-0675
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Lasik or PRK from U.S. Laser Network
In-Network
- In-Network Member Cost
- 15% off retail or 5% off promo price; call 1-800-988-4221
Out-of-Network
- Out-of-Network Member Reimbursement
- Not covered
Is This Right for You?
- Members who prefer in-network eye care with predictable co-pays
- Members needing frequent eyewear updates (High Plan)
- Members with children under 19 needing polycarbonate lenses at no co-pay
Who Can Enroll
- 👨👩👧👦You may enroll your eligible dependents in many of the same plans you choose for yourself. Eligible dependents include:
- Your legal spouse
- Your natural, adopted, or stepchildren up to age 26 (unless disabled)
Main Advantages
- ✓Choose an in-network eye doctor from the Enhanced Provider Search on eyemed.com — no ID card required, just give your name
- ✓View benefits, print ID card, check claim status, locate a provider, and download an Explanation of Benefits on the secure member portal at eyemed.com/member
- ✓Download the EyeMed Members App (App Store or Google Play) to save a vision prescription, set an eye exam reminder, or save your ID card to your wallet (iOS only)
- ✓In-network claims are handled automatically — no paperwork needed
- ✓Out-of-network claims: pay at visit, then submit a claim form online with itemized paid receipt for reimbursement
- ✓2 ID cards sent in subscriber's name upon enrollment; replacements available on member portal or via the EyeMed Members App
- ✓More than 100,000 network providers available through the Enhanced Provider Search on eyemed.com
- ✓Apply EyeMed benefits online at lenscrafters.com, targetoptical.com, ray-ban.com, glasses.com, and contactsdirect.com with free shipping and free returns
- ✓FSA funds may be used for eye exam co-pays, prescription glasses, contact lenses, contact lens solution, and LASIK surgery
- ✓HSA funds may be used for vision care out-of-pocket costs (these expenses do not count toward the annual medical deductible)
- ✓LASIK discounts available — call 1-800-988-4221 to find a US Laser Network provider
- ✓Hearing care discounts available through Amplifon Network — call 1-877-203-0675
- ✓Dependents under age 18 are listed on the member portal under the subscriber account; dependents 18 or older must register for their own account
- ✓Individual EyeMed insurance plans may be available — visit eyemed.com to check availability in your state
Limitations
- ⚠In-network discounts (40% off additional pair, 20% off non-prescription sunglasses) are for in-network providers only and may not be combined with any discount, promotional offering, or other group benefit plans
- ⚠Offers are not valid in the state of Texas
- ⚠Due to privacy rules, dependents age 18 or older are not listed on the subscriber member portal and must register separately
Ideal For
- 👤Members who want easy, paperwork-free eye care by staying in-network
- 👤Members who prefer online eyewear shopping with benefit application at checkout
- 👤Parents of young children who want guidance on recommended exam schedules (first exam between 6 months and 1 year; again between ages 3 and 5; then annually)
Provider
EyeMed
1-866-939-3633
eyemed.com