Exclusions - Vision

Important Note:

HMSA has partnered with EyeMed, service date effective January 1, 2022. HMSA transitioned our current vision portfolio to a new vision benefit with EyeMed for the following line of business: Commercial, Akamai Advantage®, QUEST Integration, Fed 87, and HMSA Plan for Postal Service Employees. HMSA will continue to be the administrators for non-routine vision services through the members medical plan(s). For more information, please contact EyeMed at www.eyemedinfocus.com

Contact by phone:
For Providers 1-888-259-4344

HMSA medical plans exclude benefits for the following services:

• Biofeedback and any other form of self-care or self-help training and any related diagnostic testing.
• Bionic services or devices
• Cosmetic services that may improve physical appearance but do not restore or materially improve a bodily function
• Experimental or investigative surgeries, therapies or treatments and services that do not follow standard medical practice
• Refractive eye surgery to correct visual acuity problems
• Self-help and self-cure programs or equipment
• Services provided by a medical professional to a member of his or her immediate family or household such as Husband or wife; Natural or adoptive parent, child, and sibling; Stepparent, stepchild, stepbrother, and stepsister; Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, and sister-in law; Grandparent and grandchild; and Spouse of grandparent and grandchild; or self (when a provider is providing professional services to themself).
• Treatment of complications resulting from previous cosmetic, experimental or investigative services, or other services not covered by HMSA plans

This list is not all inclusive. Also excluded are other medical services as itemized in the member's Guide to Benefits.

Revision History