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Diabetic Eye Care Benefit
Members who have Type 1 or Type 2 diabetes are eligible to receive supplemental coverage for additional services from their vision provider. With this benefit, you can obtain a vision evaluation every six months to monitor for signs of diabetic complications. Subject to provider determination and benefit frequency limitations, you may also receive the following diagnostic testing: Retinal imaging, extended ophthalmoscopy, gonioscopy and laser scanning. If you have questions, please contact EyeMed's Customer Care Center.
Availability of diagnostic equipment and services varies by location. Members are encouraged to call their provider to confirm availability of services.
The following chart shows how the Vision Plan pays benefits for both Type 1 and Type 2 diabetes.
Care and Service
In-Network Cost
Non-Network Reimbursement
Office Service Visit
(Medical Follow-up Exam)
$20 copayment
$77
Retinal Imaging*
$0 copayment
$50
Extended Opthalmoscopy**
$0 copayment
$15
Gonioscopy
$0 copayment
$15
Scanning Laser
$0 copayment
$33
* Not covered if extended opthalmoscopy is provided within six months.
** Not covered if retinal imaging is provided within six months.