If you carry HMSA insurance, you may be wondering whether your eye exam is covered. The short answer is yes, most HMSA members have vision benefits, but how those benefits work can be a little confusing since HMSA does not administer routine vision coverage directly.
What’s Typically Covered
Vision benefit details vary by employer group and plan, so we always recommend confirming your specific coverage before your visit. In general, HMSA vision plans routed through EyeMed may include:
- A routine eye exam, often with no copay or a low copay
- An allowance toward eyeglass frames or contact lenses, usually on an annual or calendar-year cycle
- Discounts on additional pairs of eyewear
Keep in mind that your HMSA medical plan and your HMSA vision benefit are separate. Medical eye care, such as diabetic eye exams or cataract and glaucoma management, is typically billed through your HMSA medical plan rather than your vision benefit.
Confirming Your Benefits
Because plan details differ by employer, the most reliable way to know exactly what your HMSA vision benefit covers is to check your EyeMed member portal or call the number on your card before your appointment. Our front desk is also happy to help verify your benefits when you schedule.
HMSA Vision FAQs
Yes. We participate with HMSA vision benefits through the EyeMed network, in addition to accepting HMSA for medical eye care such as diabetic eye exams and ocular disease management.
No. HMSA is your medical insurance carrier. EyeMed is the company that administers HMSA’s routine vision benefit. You may have both an HMSA card and separate EyeMed vision benefit information.
Yes. Eye exams related to a medical condition, such as diabetes, glaucoma, or cataracts, are generally covered under your HMSA medical plan rather than your vision benefit.
Coverage varies by employer group. Check your EyeMed member portal, call the number on your vision card, or ask our team to help verify your benefits before your visit.
Schedule Your Eye Exam
Not sure what your HMSA benefits cover? We’re happy to help you sort it out before your visit. Schedule your eye exam online or call us at (808) 949-2662. We’re located at 1150 S King St #201 in the eleven50 building, convenient to Makiki, Mōʻiliʻili, Ala Moana, Kakaʻako, and McCully.