Eye Care

Vision Care Reimbursement Program

Reimbursement Form

The vision care reimbursement form can be downloaded by clicking on the link here.

Order Details/Invoice

You and each member on your plan are eligible for a $200 reimbursement annually. For your reimbursement to be processed, we need to see the patient's name, what they had purchased, what services were provided, and when they received them.

Proof of Payment

Receipt (scan, photo, or PDF) can be submitted, or a copy of your bank statement, showing the following clearly: your name on the statement if you are submitting a bank/credit card statement. Payments made with a gift card or reward points do not qualify for reimbursement.