If you suspect that a provider has charged you for services you did not receive, billed you twice for the same service, or misrepresented any information, do the following: Call the provider and ask for an explanation. All rights . In some cases, due to local regulations or business practices, the doctor may be independent of the retail location. Please ask your provider for details of the warranty that is available to you. We are responsible for facilitating the process with the primary FEHB payor. This brochure describes the benefits of Blue Cross Blue Shield FEP Vision under the Blue Cross and Blue Shield Associations contract OPM02-FEDVIP-02AP-04 with OPM, as authorized by the FEDVIP law. you pay any amount over $250 frame allowance. The additional 20% discount does not apply. Try our virtual frame try-on by visitinghttps://bcbsfepvision.com/frametryon. Learn More. $190 frame allowance at MyEyeDr. Additionally, a 15% discount applies to any amount over $140.*. AskBlue - Let's discover which plan option is right for you. Protect Yourself From Fraud Here are some things that you can do to prevent fraud: If you have any questions about the eligibility of a dependent, please contactBENEFEDS. Checkthe website for additional options. When you phone for an appointment, please remember to verify that the provideris currently in-network. For the Member ID Prefix, please use the first three digits of your member ID card. Finding a provider in your network doesn't guarantee that services are covered. Blue Cross Blue Shield - EyeMed Vision Benefits You must make the change no later than 60 days after the event. Fraud increases the cost of health care for everyone and increases your Federal Employees Dental and Vision Insurance Program premium. BENEFEDS | Federal Benefits Enrollment (FEDVIP, FSAFEDS, FLTCIP) Social MediaDescription: Follow us @bcbsfepvision on Facebook and Twitter for the latest information happening at BCBS FEP Vision. How to Enroll Enrolling in BCBS FEP Vision is easy. Premium deductions will start with the first full pay period beginning on/after January 1, 2023. your former spouse after a divorce decree or annulment is final (even if a court orderstipulatesotherwise); or. Any charges for failure to keep a scheduled appointment; Any services that are strictly cosmetic in nature including, but not limited to, charges for personalization or characterization of prosthetic appliances; Services ormaterials provided as a result of intentionally self-inflicted injury or illness; Services ormaterials provided as a result of injuries suffered while committing or attempting to commit a felony, engaging in an illegal occupation, or participating in a riot, rebellion or insurrection; Charges for copies of your records, charts, or any costs associated with forwarding/mailing copies of your records or charts; State or territorial taxes on vision services and materials; Medical treatment of eye disease or injury; Special vision procedures, such as orthoptics, vision therapy or vision training; Special lens designs or coatings other than those described in this brochure; Special supplies such as nonprescription sunglasses and subnormal vision aids; Two pairs of eyeglasses in lieu of bifocals; Services not performed by licensed personnel; Professional services you receive from immediate relatives or household members, such as a spouse, parent, child, sibling, by blood, marriage or adoption. Each year, an Open Season will be held, during which you may enroll or change your dental and/or vision plan enrollment. You can find plan websites and phone numbers below. Your FEDVIP coverage will end if you retire on a Minimum Retirement Age (MRA) + 10 retirement and postpone receipt of your annuity. BCBS FEP Vision home. For coverage/benefits/provider questions regarding the Federal Employees Dental and Vision Insurance Program, you must contact the individual FEDVIP plan (s). *Position must be in a Federal agency that provides dental and/or vision coverage with 50 percent or more employer-paid premium. BCBS Plans - Blue Shield of California In addition, uniformed services active, d in aFEDVIPvision plan and want to switch to BCBS FEP Vision, you must change enrollment through BENEFEDS. Self Plus One: A Self Plus One enrollment covers you as the enrolled employee or annuitant plus one eligible family member whom you specify. You may choose a Self Plus One enrollment even though you have additional eligible family members, but the additional family members will not be covered under FEDVIP.. If you sign up for a dental and/or vision plan during the 2022Open Season, your coverage will begin on January 1, 2023. They can also view claims and approval status, view/share Explanations of Benefits (EOBs), view/share member ID cards, and locate in-network providers and access shop online retailers. *NOTE: Access StandardsUrban and suburban zip codes: at least 90% of FEDVIP eligibles in a network access area (zip code plus 15 driving-miles) must have access to a vision care preferred provider.Rural zip codes: at least 80% of FEDVIP eligibles in a network access area (zip code plus 35 driving-miles) must have access to a vision care preferred provider. Ophthalmologists and optometrists specializing in low vision care can evaluate and prescribe optical devices, and provide training and instruction to maximize the remaining usable vision for our members with low vision. However, those sites may provide a link to BENEFEDS. BCBS FEP Vision covers frames, lenses, and eye exams. Members can log in with their vision username and password to access personal eye care information such as benefits, out-of-pocket costs, and wellness information. When you visit an out-of-network provider, you will be reimbursed according to theschedule shown in the chart below. If we do not receive the information within 60 days, we will decide within 30 days of the date the information was due. Out-of-Network: Expenses in excess of fee schedule allowance of $30, Nothing for frames up to $140 frame allowance. eCraft: Espoo, Uusimaa Managed IT Services - Spiceworks For more information, please visit FEP BlueVision. You may enroll in a dental plan or a vision plan, or both. The enrollment and premium administration system for FEDVIP. Access to over 117,000 eye care providers nationwide, including Visionworks, LensCrafters, Costco, Walmart, Sam's Club, Target Optical, Pearle Vision and more An extensive fully covered Exclusive Collection of frames A $200 frame allowance with our High Option that covers about 90% of national retailers' frames in full Benefits that work overseas If you need to use your benefits now, call your local BCBS company to get your member ID. Self and Family: A Self and Family enrollment covers you as the enrolled employee or annuitant and all of your eligible family members. You must list all eligible family members when enrolling. If you enroll or are enrolled in a high deductible health plan with a health savings account (HSA) or health reimbursement arrangement (HRA), you can use your HSA or HRA to pay for qualified dental/vision costs not covered by your FEHB and FEDVIP plans. Under certain circumstances, you may also continue coverage for a disabled child 22 years of age or older who is incapable of self-support. Provider networks may be more extensive in some areas than others. What Eye Care (Including LASIK) Does FEP BlueVision Cover? To determine if you are in a limited access areacall us at1-888-550-2583 or TTY: 1-800-523-2847. If you use a participating provider to obtain covered care, benefits are paid at the in-network level. If you want to enroll or change your enrollment in this plan, please visit. BCBS FEP Vision complies with all applicable Federal civil rights laws, to include both Title VII of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act. Collection is available at participating independent provider offices. View this virtual experience on your computer or mobile device by going to bcbsfepvisionos.com. Answer a few questions and get a personalized health action plan. c) Ask you or your provider for more information. If you live in a limited access area, overseas or if you obtain services from a non-participating provider (High Option only), you are responsible for filing the claim. Provider networks may be more extensive in some areas than others. This also includes stepchildrenand foster children who live with you in a regular parent-child relationship. The following are also NOT available under the FEDVIP plans: Temporary Continuation of Coverage (TCC); right to convert to an individual policy (conversion policy). In response to the legislation, OPM established the Federal Employees Dental and Vision Insurance Program (FEDVIP). To receive covered benefits, you must stay in-network if you are enrolled in Standard Option. How to Enroll Virtual Benefits Experience chapter 55 based on their direct affiliation with the uniformed services (including military members of the National Guard and Reserves). Your cancellation is effective at the end of the day before the date OPM sets as the Open Season effective date. See. Choose from a 4-month gym membership, a Fitbit® and more. All eligible dependents listed on your enrollment share your identification number. You, and your family members, do not have a right to benefits that were available before January 1, 2023 unless those benefits are also shown in this brochure. If the provider you use is not part of our network, benefits will be considered out-of-network. Thats why we give you resources like the Prescription Drug Cost Tool. FEP Vision - Home You may need to pay the provider in-full at the time of service and you will be reimbursed up to the amounts shown below: Services/Material: Vision CareExamHigh Option We Pay: Up to $60Standard Option We Pay: Up to $60, Services/Material: Single Vision LensesHigh Option We Pay: Up to $72Standard Option We Pay: Up to $72, Services/Material: Bifocal LensesHigh Option We Pay: Up to $109Standard Option We Pay: Up to $109, Services/Material: Trifocal LensesHigh Option We Pay: Up to $136Standard Option We Pay: Up to $136, Services/Material: Lenticular LensesHigh Option We Pay: Up to $136Standard Option We Pay: Up to $136, Services/Material:Contact LensesHigh Option We Pay: Up to $150Standard Option We Pay: Up to $140, Services/Material: Medically Necessary Contact LensesHigh Option We Pay: Up to $600Standard Option We Pay: Up to $600, Services/Material: FramesHigh Option We Pay: Up to $200Standard Option We Pay: Up to $140. Note:You may choose prescription glasses or contacts. (from single vision to bifocal). Note: If you are an active-duty uniformed service member, your dental and vision coverage will be provided by TRICARE. Important things you should keep in mind about these benefits: Please remember that all benefits are subject to the definitions, limitations and exclusions in this brochure and are payable only when we determine they are necessary for the prevention, diagnosis, care or treatment of a covered condition and meet generally accepted protocols. See www.fsafeds.com or call 1-877-FSAFEDS (372-3337) or TTY: 1-866-353-8058. If prescription changes, one additional pair of lenses covered in full for High Option members, $10 copay for Standard Option members. You do not need to re-enroll each Open Season unless you wish to change plans or plan options;your coverage will continue from the previous year. If prescription changes, one additional pair of lenses covered in full for High Option members, $10 copay for Standard Option members and one additional pair of frames collection frames covered in full, non-collection frames subject to allowance, plus a 20% discount on any amount over the allowance. Generally, a sponsor means the individual who is eligible for medical or dental benefits under 10 U.S.C. you pay any amount over $250 frame allowance. ET Fill out the Contact Us form There may be an error. Blue Cross Blue Shield FEP Dental - Home Expenses in excess of $600 for medically necessary contact lenses.**. 1.7 37 Ratings Free Screenshots iPhone iPad Find in-network eye care professionals nearby, then get directions, or call to schedule an appointment. Plus! The law directed the Office of Personnel Management (OPM) to establish supplemental dental and vision benefit programs to be made available to Federal employees, annuitants, and their eligible family members. Rural zip codes: at least 80% of FEDVIP eligibles in a network access area (zip code plus 35 driving-miles) must have access to a vision care preferred provider. Out-of-networkinsurance plans available. If you live in an area that does not have adequate access to an BCBS FEP Vision network provider and you receive covered services from an out-of-network provider, we will pay up to 100% of our Plan Allowance. Participating providers will bill you for anything over the $60 less the discount so you do not have to file a claim. Section 715 of the National Defense Authorization Act for Fiscal Year 2017 (FY 2017 NDAA), Public Law 114-38, expanded FEDVIP eligibility to certain TRICARE-eligible individuals. At MyEyeDr. There may be an additional charge at Costco, LensCrafters, Target Optical, Pearle Vision,Sams Club, Walmart and Warby Parker. Home - Blue Cross and Blue Shield's Federal Employee Program Blue Cross Blue Shield FEP Dental - Home Aetna Vision Preferred (external link) 2. Enrollment in the FEHB Program or the Health Insurance Marketplace (Exchange) is not required. Access your ID card and personalize it with a pic (optional). Because these providers are out of the BCBS FEP Vision network, we will reimburse you up to the maximum reimbursement amount allowed by the plan (see fee schedule allowances as described in Section 4, Your Cost For Covered Services). We'd suggest starting in one of these areas: Easily view and share your member ID card, Earn $50 when you take the Blue Health Assessment, Earn a reward for having your annual checkup. In addition, uniformed services active-duty family members who are enrolled in a TRICARE health plan are eligible for FEDVIP vision coverage. The Helsinki and Uusimaa Hospital District (HUS) has selected Innofactor as the provider of ICT consultancy . Blue Cross Blue Shield FEP Dental takes the health and well-being of our members, providers, our associates and our business partners seriously. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. You must use BENEFEDS to enroll or change enrollment in a FEDVIP plan. Generally, enrollments and enrollment changes made based on a QLE are effective on the first day of the pay period following the one in which BENEFEDS receives and confirms the enrollment or change. For a health care or limited expense account, each participant must contribute a minimum of $100 to a maximum of $3,050. The application provides members with 24/7 access to helpful features, tools and information related to Blue Cross and Blue Shield FEP Vision benefits. Doctor Finder. Try our visionsimulator by visitinghttps://bcbsfepvision.com/visionsimulator. Please be aware that the BCBS FEP Vision network is different from the network of your health plan. FEP members with type 1 and type 2 diabetes are eligible for our diabetes management program (including members with Medicare as primary.) Changes to both our High and Standard Options include: Changes to our Standard Option only include: If you are a Federal or U.S. Annuitants are sometimes called retirees. This also includes those receiving compensation from the Department of Labors Office of Workers Compensation Programs, who are called compensationers. Follow this disputed claims process if you disagree with our decision on your claim or request for services. Your family members may also be able to continue enrollment after your death. If you are planning to enroll in an FSAFEDS Health Care Flexible Spending Account (HCFSA) or Limited Expense Health Care Flexible Spending Account (LEX HCFSA), you should consider how coverage under a FEDVIP plan will affect your annual expenses, and thus the amount that you should allot to an FSAFEDS account. your child over age 22 (unless they are disabled and incapable of self-support). Carefully consider the amount you will elect. Plans for federal employees, retirees, retired uniformed service members, and . Some TRICARE beneficiaries may not be eligible to enroll in both. Table of Contents. Note: FSAFEDS is not open to retired employees, or to TRICARE eligible individuals. You can select from several nationwide, and in some areas, regional dental Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO) plans, and high and standard coverage options. The effective date of these Open Season enrollments and changes will be set by OPM. If your vision care provider is in theparticipating network, theywill file the claim for you, and payment will be sent directly to the vision care provider. To enroll, you will be taken to the BENEFEDS website. In honor of National Postal Workers Day on July 1, we want all postal workers to know how much we appreciate everything you do. AskBlue BCBS FEP Vision Plan FinderDescription: Need help choosing between High Option and Standard Option? Retail chain providers typically do not display the Collection, but are required to maintain a comparable selection of frames that are covered in full. After pre-authorization by BCBS FEP Vision, covered low vision services (both in- and out-of-network) will include one comprehensive low vision evaluation every 5 years, with a maximum charge of $300; maximum low vision aid allowance of $600 with a lifetime maximum of $1,200 for items such as high-power spectacles, magnifiers and telescopes; and follow-up care four visits in any five-year period, with a maximum charge of $100 each visit. Low Vision: Low vision is a significant loss of vision but not total blindness. When you visit a BCBS FEP Vision network doctor, yourvision care exam is covered in full and prescription glasses or contacts are covered after any co-payments. Federal Employees Dental and Vision Insurance Program brochure You will also receive 20% off any out-of- pocket costs over your frame allowance and a savings of 15% on any balance over your conventional contact allowance. You may also request or view the most current directory via our website at www.bcbsfepvision.com. The protection of your privacy will be governed by the privacy policy of that site. You do not need an ID card for each member of your family. The prescription must have changed at least 0.5 diopter or the seg height changed at least a 5.0 millimeter, or lens type changed, e.g. We have 30 days from the date we receive your request to: a) Pay the claim or b) Write to you and maintain our denial or c) Ask you or your provider for more information. To review full details about our privacy practices, our legal duties, and your rights, please visit our website, You can select from several nationwide, and in some areas, regional dental Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO) plans, and high and standard coverage options. Additionally, a 15% discount applies to any amount over $150.*. Contact Us - BCBS FEP Vision Additional 20% discount does not apply. You are responsible for charges billed over the amounts shown. Benefit applies to children 13 years of age and under. Covered services or payment for covered services to which enrollees and covered family members are entitled to the extent provided by this brochure. . Under circumstances where a sponsor is not an enrollee, a TEI family member may accept responsibility to self-certify as an enrollee and enroll TEI family members. We do not coordinate benefits with non-FEHB health plans. Claim forms are available at www.bcbsfepvision.comor via email at fepmemberhelp@davisvision.com. The decision of the independent third party is binding on us and is the final administrativereview of your claim. Thank you for keeping us connected. In just 10 minutes, you can answer some simple questions and get recommended a plan based on your needs. Expenses in excess of a $150 allowance. Using your FSAFEDS account for your eyecare and eyewear expenses is simple: Visit your provider for your vision care exam and eyewear. Blue Cross Blue Shield is a nationally-known carrier in the Federal Employees Dental and Vision Insurance Program (FEDVIP) and is proud to offer Blue Cross Blue Shield FEP Vision to federal employees, federal retirees, retired uniformed service members and their families, plus families of active duty service members. Contact us at 1-888-550-2583 orTTY: 1-800-523-2847 for the names ofparticipating providers or to request aprovider directory. If you or one of your family members is enrolled in or covered by one FEDVIP plan, that person cannot be enrolled in or covered as a family member by another FEDVIP plan offering the same type of coverage; e.g., you (or covered family members) cannot be covered by two FEDVIP dental plans or two FEDVIP vision plans. Healthcare Plan Information For Vision - OPM.gov location. BCBS FEP Vision is responsible for the selection of in-network providers in your area. The timeframe for requesting a QLE change is from 31 days before to 60 days after the event. The FEDVIP law does not provide a role for OPM to review disputed claims. BCBS FEP Vision also offers several in-network e-commerce options such as:1800contacts.com, befitting.com, glasses.com,visionworks.com and warbyparker.com. Follow this disputed claims process if you disagree with our decision on your claim or request for services. If prescription changes, one additional pair of lenses covered in full for High Option members, $10 copay for Standard Option members and one additional pair of frames collection frames covered in full, non-collection frames subject to allowance, plus a 20% discount on any amount over the allowance. Members get access to over 55,000 Preferred pharmacies in the U.S. You can easily view and access your claims and statements. Because of the tax benefits an FSA provides, the IRS requires that you forfeit any money for which you did not incur an eligible expense and file a claim in the time period permitted. High Option members will have a $250 allowance and Standard Option members will have a $190 allowance at over 800 MyEyeDr. Please tell us a bit more about yourself: Interested in BCBS FEP: New Federal Employee. If you receive care from a non-participating provider, we will not pay for any services unless you reside in a limited access area. We increased the annual contact lens allowance to $140. Contact Lenses: covered once every calendar year in lieu of eyeglasses. We offer additional benefits for children age 13 and under. Your family members will still be eligible to enroll in the TRICARE Dental Plan (TDP). Services/Material: Vision CareExamWe Pay: Up to $30Services/Material: Single Vision LensesWe Pay: Up to $25Services/Material: Bifocal LensesWe Pay: Up to $35Services/Material: Trifocal LensesWe Pay: Up to $45Services/Material: Lenticular LensesWe Pay: Up to $45Services/Material: Elective Contact LensesWe Pay: Up to $75Services/Material: Medically Necessary Contact LensesWe Pay: Up to $225Services/Material: FramesWe Pay: Up to $30. You cannot request a new enrollment based on a QLE before the QLE occurs, except for enrollment because of loss of dental or vision insurance. Plus, there are no claim forms to submit when you see an in-network doctor. This brochure describes the benefits of Blue Cross Blue Shield FEP Vision under the Blue Cross and Blue Shield Association's contract OPM02-FEDVIP-02AP-04 with OPM, as authorized by the FEDVIP law. FEP BlueVision is a comprehensive product, and eligible federal employees who select it will gain access to Davis Vision's extensive network of providers, its proprietary delivery system and administrative services through all Blue plans across the United States and its protectorates. (Page numbers solely appear in the printed brochure), Continued Group Coverage After Retirement, Opportunities to Enroll or Change Enrollment, FSAFEDS/High Deductible Health Plans and FEDVIP, Identification Cards/Enrollment Confirmation, Customer Service Website and Phone Numbers, TRICARE-eligible individual (TEI) family member. Backed by the strength of Blue Cross Blue Shield, we're proud to offer plans that help keep your mouth and eyes healthy. You may enroll within 60 days after you become eligible as: Your enrollment will be effective the first day of the pay period following the one in which BENEFEDS receives and confirms your enrollment. A qualifying life event (QLE) is an event that allows you to enroll, or if you are already enrolled, allows you to change your enrollment outside of an Open Season. If the dispute is not resolved through the reconsideration process, you may request a review of the denial. This is a summary of the many features and benefits of BCBS FEP Vision. Example: The BCBS FEP Vision High Option and Standard Option plans, have a $0 copay for a vision care exam. Youcan submit your out-of-network claim electronically using the mobile app, member log-in portal on our website or you can obtain claim formson the website at. The following persons are not eligible to enroll in FEDVIP, regardless of FEHB eligibility or receipt of an annuity or portion of an annuity: Note: Former spouses of TRICARE-eligible individuals may enroll in a FEDVIP vision plan. As your health needs evolve, our diverse plans are designed to evolve with you. Note: Collection frames with retail values up to $195 are available at no cost at most participating independent providers. This copay does not apply to the High Option. YourFEDVIP enrollment will continue into retirement, if you retire on an immediate annuity or for disability under CSRS, FERS or another retirement system for employees of the Government, regardless of the length of time you had FEDVIP coverage as an employee.