Vision Benefits
How does the ESSENCE Vision Care benefit work?
Do I have to go to specific providers?
Yes, to use your ESSENCE vision benefits you must use a “Routine Vision Care Provider” listed as such in the ESSENCE Provider
Directory for routine eye exams (no eye related problems) or to obtain eyeglasses or contact lenses **.
If you have eye problems i.e. cataracts, glaucoma, need eye surgery etc., you must obtain a referral from your Primary Care Physician
to see one of the Ophthalmologist, listed as such in the ESSENCE Provider Directory.
If you need glasses or contact lenses for any reason they must be purchased from a “Routine Vision Care Provider” to be covered
by ESSENCE.
When do I go to a Routine Vision Care Provider?
For a routine eye exam (no eye related problems) or to purchase eye glasses or contact lenses**.
Do I need a referral for routine vision care?
No, you may go to a “Routine Vision Care Provider” for a routine eye exam (no eye related problems) without a referral from your
Primary Care Physician **.
If I have a medical eye condition do I need a referral?
Yes, you must obtain a referral from your Primary Care Physician to see an ESSENCE Ophthalmologist.
Can I purchase my glasses or contact lenses from any ESSENCE Provider in the ESSENCE Provider Directory?
No, you must visit one of the “Routine Vision Care Providers” listed as such in the ESSENCE Provider Directory. If you purchase
your glasses or contact lenses from an ESSENCE provider that is not listed specifically in the “Routine Vision Care Provider”
section they will not be covered under your ESSENCE vision benefits.
Consult your Evidence of Coverage for applicable coverage limits.