For most vision insurance plans, Rx-Safety.com will be considered an out-­of-­network provider.

You can submit your Rx-Safety eyewear purchase for reimbursement by following these three steps:

  1. Complete the Out-of-Network Reimbursement Form for your provider. Below you will find forms for some of the most popular providers, as well as a blank form for any others.
  2. Attach your itemized Rx-Safety.com order receipt or invoice (these will be emailed to you and included with your actual purchase).
  3. Submit the receipt along with the form to your vision insurance company.

Remember: If you don’t see your insurance provider listed below, you may use this generic reimbursement form to submit your claim.


Insurance Providers

Click on your insurance provider below for details on how to submit your insurance claim form.

ADVANTICA

You can get your Rx-Safety purchase reimbursed by Advantica if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-866-425-2323.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized ME2G.com receipt to:

Advantica
Attn: Claims Department
3290 Pine Orchard Lane, Suite C
Ellicott City, MD 21042

NOTE: You must submit your out-of-network reimbursement request within one year from the date of purchase.

DAVIS VISION

You can get your Rx-Safety purchase reimbursed by Davis Vision if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-800-999-5431.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110

NOTE: Your out-of-network reimbursement form must be submitted within 180 days from the date of purchase.

EYEMED

You can get your Rx-Safety purchase reimbursed by EyeMed if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-866-4EyeMed (439-3633)

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111

NOTE: You must submit your out-of-network reimbursement request within one year from the date of purchase.

HUMANA VISION

You can get your Rx-Safety purchase reimbursed by Humana Vision if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-866-537-0229.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

Humana Vision Care Plan
Attn: OON Claims
P.O. Box 14311
Lexington, KY 40512-4311

NOTE: You must submit your out-of-network reimbursement request within one year from the date of purchase.

SPECTERA

You can get your Rx-Safety purchase reimbursed by Spectera if out-of-network benefits are included in your plan. You can review your benefits here.

DOWNLOAD REIMBURSEMENT FORM

Submit your reimbursement request and itemized FramesDirect.com receipt to:

Spectera Claims Department
P.O. box 30978
Salt Lake City, UT 84130

Or Fax: 248-733-6060

NOTE: You must submit your out-of-network reimbursement request with your itemized receipt and the following information: Subscriber’s name and address, the patient’s name and date of birth, and the subscriber’s unique identification number. This number can be found on your membership card, on the Spectera website, or by calling 1-800-638-3120. For convenience, you can complete our blank out-of-network reimbursement form.

SUPERIOR VISION

You can get your Rx-Safety purchase reimbursed by Superior Vision if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-800-507-3800.

You will need to contact Superior Vision Customer service at 1-800-507-3800 to obtain an authorization number prior to using your out-of-network benefits. After obtaining out-of-network services, you will need to file a claim form as well as an itemized receipt.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

Superior Vision Services
Attn: Claims Processing
P.O. Box 967
Rancho Cordova, CA 95741

Or Fax: 916-852-2277

VISION BENEFITS OF AMERICA

You can get your Rx-Safety purchase reimbursed by Vision Benefits of America if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-800-432-4966.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

Vision Benefits of America
300 Weyman Plaza, Suite 400
Pittsburg, PA 15236-1588

VSP

You can get your Rx-Safety purchase reimbursed by VSP if out-of-network benefits are included in your plan. You can review your benefits here or by calling 1-­800-­877-­7195.

DOWNLOAD REIMBURSEMENT FORM

Submit your completed reimbursement form and itemized FramesDirect.com receipt to:

VSP
P.O. 997105
Sacramento, CA 95899-7105


Flexible Spending

Your flexible spending or health savings accounts (HSA) dollars can be used to purchase prescription eyeglasses and, in some cases, prescription sunglasses? This is true whether or not you have vision insurance. Additionally, if you use your flex spending or HSA debit card, you can skip the hassle of having to submit a reimbursement form to your insurance provider. Read more here.


QUESTIONS?

Call one of our customer service experts at 1-866-653-5227 for more information about using your out-of-network benefits on your Rx-Safety.com purchase.

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