EyeMed and Community Eye Care in the Upstate: What's Covered

Most confusion about vision benefits comes from one misunderstanding. A vision plan is not medical insurance. It is closer to a discount and allowance program with an annual budget attached. Once you see it that way, the rules stop feeling arbitrary.

We accept Community Eye Care and select EyeMed plans, and CareCredit is available for qualifying purchases. Below is what those plans generally cover, with the important caveat that the details depend on the specific plan your employer bought.

The four parts of almost every vision plan

1. The routine exam

Usually covered once per benefit period, with a modest copay. A routine exam establishes your prescription and checks eye health. If the visit turns into treatment of a medical condition, that part is generally billed to medical insurance instead, which is a different bucket entirely.

2. A frame allowance

A fixed dollar amount toward a frame, typically once every twelve or twenty four months. Anything above the allowance is yours to pay, often at a discounted rate. Allowances rarely cover a designer frame in full, and any office that tells you otherwise is describing a different kind of frame.

3. A lens benefit

Basic single vision, bifocal or progressive lenses are usually covered at a copay. Upgrades such as high index materials, premium progressive designs, anti reflective coatings, photochromic and polarized lenses are typically an additional cost, sometimes at a plan negotiated rate. This is where most out of pocket spending actually happens, and it is worth understanding before you choose. Our lens guide explains what each upgrade does.

4. Contact lenses instead of glasses

Nearly every plan makes you choose. You take either the frame and lens benefit or the contact lens allowance in a given period, not both. Contact lens fittings are often a separate charge from the routine exam, because fitting involves measurements and a follow up that a glasses exam does not. See our contact lens page.

Community Eye Care

Community Eye Care is a regional vision plan familiar to a lot of employers in South Carolina, and we accept it. As with any plan, the exam coverage, the frame allowance and the lens copays are set by the specific plan design your employer selected, so two people holding the same card can have different benefits.

Select EyeMed plans

EyeMed is a national network, and it is the plan people ask about most. We accept select EyeMed plans. The word select is doing real work in that sentence: EyeMed sells many plan tiers through many employers, and network participation and benefit levels differ between them. Rather than guess, call us with your card and we will verify your specific plan before you book.

What to have in front of you when you call

Your plan card, the member identification number, your employer name, and the date of your last exam and last pair of glasses. Those last two decide whether your benefit period has reset. With that information we can tell you what applies here before you commit to an appointment.

Out of network does not mean no benefit

If a plan we do not participate in is the only one you have, you still have options. Many plans reimburse out of network purchases at a reduced rate: you pay at the time of service, we provide an itemized receipt, and you submit it for reimbursement. It is more paperwork, but it is not a dead end, and it is often the route people take when they want a specific independent frame their in network shop does not carry.

CareCredit and timing

CareCredit financing is available for qualifying purchases, which helps when a benefit period does not line up with when you actually need glasses. On timing: most benefit periods reset with the calendar year and unused allowances do not carry over. If you have not used this year's benefit by late autumn, December books up quickly across every optical office in the Upstate, ours included. Booking in October or November is the calmer path.

What we will always do

Tell you the cost before we order anything, explain which lens upgrades will change your day and which will not, and never let a benefit allowance push you toward a frame that does not suit you. If the honest answer is that your plan covers very little of what you want, you will hear that from us plainly rather than at pickup.

Call 864-502-0102, or see our contact page for hours and directions. Saturday appointments run every Saturday from 8:30 AM to 1:00 PM, and clients come to us from across the Upstate.