How do the vision plans compare?

Before you enroll in a vision plan, use the Vision Benefits At-a-Glance Comparison to get the details you need to help you decide. 

For information on specific benefits and exclusions, review the plan's certificate of coverage (COC) or call the plan.

What does a vision plan cover?

Vision plans cover:

• An eye exam (once every year)
• A set of lenses (Benefit resets every January 1 of odd years)

Vision plans give an allowance toward new frames or contacts (in lieu of glasses) every January 1 of odd years (2025, 2027, etc.)

Some plans may also include discounts on laser vision correction, or LASIK.

Does my medical plan cover vision?

Your medical plan covers general eye health.

If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or an injury, then your medical plan will more than likely cover you. These types of claims would fall under medical insurance; whereas a vision exam and glasses would fall under vision insurance.

For example: If your eye doctor was fitting you for contact lenses and discovered a torn retina, your medical plan would cover further exams and visits until it was resolved. A torn retina is a medical problem, not a vision correction issue.

What providers can I see?

Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.

Davis Vision by MetLife

Visit Davis Vision by MetLife's provider search.

EyeMed

Visit EyeMed's provider search.

MetLife Vision

Visit MetLife Vision's provider search.

Preauthorization criteria

Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.

Davis Vision

EyeMed

MetLife Vision

These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Why is frenotomy and frenectomy being reviewed?

Frenectomy and frenotomy for breastfeeding support were selected for a health technology assessment (HTA) because of high concerns for efficacy, and medium concerns for safety and cost.

Primary criteria ranking

• Safety = Medium
• Efficacy = High
• Cost = Medium

Documentation

What is a CCBHC?

A CCBHC is a provider who has met the SAMHSA requirements for eligible providers and the criteria to provide all required services. They must provide service to any individual who presents in their clinic, regardless of ability to pay or insurance.

Areas of service

Clinics must provide nine total areas of service:

• Screening, assessment, diagnosis
• Patient-centered treatment planning
• Outpatient mental health/substance use disorder treatment
• Crisis services (24-hour mobile crisis, crisis stabilization)*
• Peer support
• Psychiatric rehab
• Targeted case management
• Primary health screening and monitoring
• Armed forces and veteran’s services

A minimum of 51 percent of the services must be provided by the CCBHC, with the remainder provided by either the CCBHC or a Designated Collaborating Organization (DCO).

Our state has the goal to increase the number of CCBHCs so that every Washingtonian can easily access the services. Visit the CCBHC locator to find a clinic near you.

*After-hours crisis services may be provided by a state-sanctioned system.