Frequently Asked Questions
Coverage QuestionsDependent Questions
Can a member term their vision coverage mid-year?
A member can terminate coverage if they have a qualifying event, i.e., marriage, divorce, birth, etc. or if they have terminated employment. Otherwise they will have to wait until the next open enrollment anniversary to dis-enroll.
Do you cover domestic partners under the vision program?
Yes, Avesis will cover domestic partners if the employer offers benefits to employees with domestic partners.
What are medically necessary contacts?
Medically Necessary Contacts are required when a vision care provider has determined that spectacle lenses and frames would not achieve the best vision correction possible due to a medical condition.
In most cases diagnosis such as:
- Keratoconus
- Corneal traum
- Post cataract surgery
- Anisometropia
will qualify a member for medically necessary contacts. Prior approval is required for services.
Can an employee elect COBRA after they have terminated employment?
Yes, Avesis offers COBRA to terminated employees. If Avesis does not administer coverage, the employer is responsible to continue administering the benefit.
Up to what age is an eligible dependent covered?
The eligible dependents are generally covered up to age 19 , or if a full time student to age 25. The exact age limitations are specified in your group's insurance certificate and vary by state.