File a vision claim

Online filing and setting up direct deposit are the fastest ways to start receiving the benefits you need. You can file a vision claim if you or a dependent on your policy had a vision exam or purchased glasses or contact lenses.

Image of a smiling lady overlooking a membership vision card

How to file a PPO claim:

For quick processing complete all sections on the form and be sure to include the following information:

  • Your name, date of birth, Social Security number (SSN) and address
  • Claimant’s name and date of birth (if other than primary insured)
  • Your member number
  • A detailed receipt of services for reimbursement

For the second part of the form, have your eye care professional complete the section titled “Provider Information” and have them attach a copy of the statement of services or the pretreatment estimate.

Image of a smiling male interacting with his computer

How to file a Fee Schedule claim

To ensure quicker processing complete all sections on the form and be sure to include the following information:

  • Your name, date of birth, Social Security number (SSN) and address
  • Claimant’s name, date of birth, SSN (if other than primary insured)
  • Treating physician’s information (must be an optometrist or ophthalmologist)
  • Date of vision exam and the date you purchased your eyeglasses or contact lenses
  • A detailed receipt of services for reimbursement

By fax: 800-880-9325

By mail: Claims Department
P.O. Box 100195 Columbia, SC 29202