VISION INSURANCE
Blue View Vision will be the vision provider starting January 1, 2024.
Vision Benefits Overview
Vision Benefits Overview
Plan Benefits and Network:
The new plan provides the same benefits and network as last year's (plan year 2023) vision plan.
The Blue View Vision network uses the same network as EyeMed does. This means that your previous (2023) EyeMed in-network optometrist will also be an in-network Blue View Vision provider.
Please note that individual optometrist participation in any network is subject to change at any time, as optometrist and facility participation in a network is contractual.
No card is needed to seek in-network services. Just provide your name and date of birth for your in-network optometrist to locate you in their system.
However, a new card will be mailed to each subscriber, and is anticipated to arrive before January 1, 2024.
• You can still access out-of-network services and file a claim for reimbursement.
• Your medical vision services (Ophthalmology) are unchanged and still managed by your medical plan provider. This change to your stand-alone vision provider has no impact on your medical benefits.
• You do not have to elect Blue View Vision during Open Enrollment
— Employees and their eligible dependents enrolled into LAwell medical coverage will automatically be enrolled into the vision plan.
— Enrollment into vision is still linked to enrollment in medical coverage. No changes can be independently made to covered dependents for vision coverage.
— Employees electing Cash-in-Lieu will be automatically enrolled in the Employee-Only level of vision coverage. However, employees who are covered as a dependent of another City employee will only receive one coverage benefit as a dependent.
Access Services
Access Services
The Blue View Vision Network
Blue View Vision provides care through a network of vision care specialists who have agreed to offer covered services at discounted rates. The Blue View Vision network has over 42,000 providers, at over 32,000 locations including independent providers plus national retail chains such as LensCrafters®, Target Optical®, and most Pearle Vision® locations.
To access benefits, all you need is to provide your name and date of birth to an in-network Blue View Vision Plus provider provider. ID cards are not needed, but ID cards can be printed by visiting LAwellvision.org
To find a network provider near you:
Visit LAwellvision.org and click the “Find Care” button.
Download the Sydney Health mobile app (available in the Apple App Store and Google Play) and choose the Insight network from the list of network options.
Call the Blue View Vision Customer Care Center at 877-635-6403
Out-of-Network Providers
You can visit a vision care provider who does not participate in the Blue View Vision network and still receive benefits for covered services. You will be reimbursed up to a maximum dollar amount if you provide Blue View Vision with an itemized receipt and a completed claim form. Claim forms are available at LAwellvision.org or by calling the Blue View Vision Customer Care Center at 877-635-6403.
Online Account & Contacts
• Your existing EyeMed online account will not transfer over to Blue View Vision. Visit the City of Los Angeles Blue View Vision microsite at LAwellVision.org to register a new online account with Blue View Vision. Upon your first visit, you will need to create an account by entering your first and last name, date of birth, and last four digits of your SSN.
Blue View Vision & Medical Plans
Blue View Vision & Medical Plans
How Blue View Vision Benefits Work with Medical Plan Vision Benefits
Anthem and Kaiser members who prefer to receive an annual vision exam through their medical plan providers may do so but are not entitled to an eyewear allowance through their medical plan. Eyewear (frames, lenses, and contacts) received from a medical plan provider may be submitted to Blue View Vision for reimbursement as an out-of-network provider. Members may also visit a Blue View Vision in-network provider using their medical plan provider prescription and purchase eyewear using their Blue View Vision materials benefit.
The table below outlines how your Blue View Vision benefit can be used with your medical plan.
Note: Allowances may vary per specific benefit, based on the type of benefit item purchased, and do not apply to all benefits
| Description |
Blue View Vision |
Kaiser |
Anthem |
|---|---|---|---|
| Routine Eye Exam | Covered with copay | Covered with copay | Not covered |
| Eyewear – Frames, Lenses, or Contacts |
Up to $150 allowance every year (does not roll over if not used) |
Not covered (Partial reimbursement available from Blue View Vision if member files an out-of-network claim.) |
|
| Medical Eye Exams (e.g., screening for medical vision conditions like glaucoma and cataracts) |
Check with Blue View Vision provider before seeking medical/ ophthalmology-related services |
Covered with copay | Covered with copay Primary care physician (PCP) referral and/or medical group authorization may be required under HMO plans. Please contact your PCP for information regarding their referral process before seeking care from a specialist. |
| Treatment of Vision Conditions (e.g., glaucoma and cataracts) |
Not covered | Covered with copay | Covered with copay Primary care physician (PCP) referral and/or medical group authorization may be required under HMO plans. Please contact your PCP for information regarding their referral process before seeking care from a specialist. |
Annual Benefit Details
Annual Benefit Details
Benefits are available to you and your covered dependents once every twelve months.
| Your Blue View Vision Plan Benefits | In-Network | Out-of-Network | Frequency |
|---|---|---|---|
| Routine Eye Exam | |||
| A comprehensive eye examination | $10 copay | $Up to45 reimbursement | Once every 12 months |
| A comprehensive eye examination at a PLUS Provider | $0 copay | Not covered | |
| Eyeglass Frames | |||
| One pair of eyeglass frames | $150 allowance, then 20% off any remaining balance | Up to $104 reimbursement | Once every 12 months |
| One pair of eyeglass frames at a PLUS Provider | $200 allowance, then 20% off any remaining balance | Not Covered | |
| Eyeglass Lenses (instead of contact lenses) | |||
| One pair of standard plastic prescription lenses: | |||
| Single Vision lenses Bifocal lenses Trifocal lenses Lenticular lenses |
$10 copay $10 copay $10 copay $10 copay |
Up to $35 reimbursement Up to $70 reimbursement Up to $65 reimbursement Up to $65 reimbursement |
Once every 12 months |
| Eyeglass Lens Enhancements When obtaining covered eyewear from a Blue View Vision provider, you may choose to add any of the following lens enhancements at no extra cost. |
|||
| Transition Lenses (for a child under age 19) Standard polycarbonate (for a child under age 19) Factory scratch coating Retinal imaging (obtained during covered eye exam) |
$0 copay $0 copay $0 copay $10 copay |
Not Covered Up to $28 reimbursement Not Covered Up to $21 reimbursement |
Same as covered eyeglass lenses |
| Contact Lenses (instead of eyeglass lenses) Contact lenses allowance will only be applied towards the first purchase of contact made during a benefit period. Any unused amount remaining cannot be used for subsequent purchases in the same benefit period , nor can any used amount be carried over to the following benefit period. |
|||
| Elective conventional (non- disposable) | $150 allowance, the 15% off any remaining balance | Up to $120 reimbursement | Once every 12 months |
| OR | |||
| Elective disposable | $150 allowance (no additional discount) | Up to $120 reimbursement | |
| OR | |||
| Non- elective (medically necessary) | Covered in full | Up to $120 reimbursement | |
In addition, the following benefits are available:
Retinal Imaging benefit
Retinal imaging uses a laser to scan the eyes and then produces digital images of the retinas. The images can be useful in finding abnormalities and comparing the condition of retinas from year to year. You may receive one retinal screening every 12 months for an additional $10 copay.
Diabetic eye care benefit
Your vision plan will include a benefit that provides follow-up care and supplementary diagnostic testing for members with type 1 or type 2 diabetes. With this benefit, eligible members can obtain an additional vision evaluation every six months to detect or monitor signs of diabetic complications. Diagnostic testing once every six months, including fundus photography (retinal imaging), extended ophthalmoscopy, gonioscopy, and laser scanning, is available with no in-network copay, subject to provider determination. An out-of-network reimbursement is also available.