If you have vision insurance through VSP or EyeMed, you may be wondering – can I use my benefits at Walmart Vision Centers?
The short answer is yes, you can use your VSP or EyeMed vision benefits at Walmart. However, there are some important catches:
Walmart vision centers are considered out-of-network providers by both VSP and EyeMed.
This means you‘ll need to have out-of-network coverage to get reimbursed for any vision care services at Walmart, such as eye exams and eyewear. You‘ll also likely pay more out-of-pocket compared to seeing an in-network provider.
Below I‘ll explain in detail how the out-of-network status impacts your VSP and EyeMed benefits at Walmart. I‘ll also overview how to file vision insurance claims and the key differences between VSP and EyeMed.
As an ecommerce business owner who spends lots of time evaluating insurance plans, I‘ll provide tips for maximizing your vision benefits at Walmart!
Are VSP & EyeMed In-Network With Walmart?
Unfortunately, Walmart Vision Centers are considered out-of-network providers for both VSP and EyeMed as of 2023.
This has three big implications:
You must have out-of-network coverage as part of your specific VSP or EyeMed vision plan to receive any reimbursement for Walmart visits. Without this, you‘ll foot the entire bill out-of-pocket.
You‘ll likely pay more at Walmart compared to visiting an in-network vision provider. Your out-of-pocket costs will be higher.
Reimbursements will be lower. Your insurance will cover less of your total costs when going out-of-network.
You miss out on in-network perks. VSP and EyeMed offer special discounts and deals only for in-network providers.
According to VisionWatch, a leading vision care industry report, nearly 40% of stand-alone vision plan enrollees now have out-of-network benefits. So be sure to double check your coverage!
What Does VSP Cover at Walmart Vision Centers?
With out-of-network coverage, your VSP plan will provide some reimbursement on vision care services at Walmart such as:
- Eye exams to check your vision prescription and eye health
- Eyeglasses including lenses and frames
- Contact lens exams and contacts
However, your specific reimbursement rate will depend on your plan. Expect to pay more out-of-pocket vs seeing a VSP network provider.
For example, here are hypothetical reimbursement scenarios for a $200 eye exam and $400 glasses at Walmart with an average VSP plan:
- Eye Exam
- VSP Network: $10 copay
- Walmart Out-of-Network: $80 reimbursement, $120 out-of-pocket
- VSP Network: $40 copay
- Walmart Out-of-Network: $200 reimbursement, $200 out-of-pocket
As you can see, your personal costs are significantly higher without the in-network discounts! Make sure to review your VSP plan details.
What Does EyeMed Cover at Walmart Vision Centers?
Similar to VSP, EyeMed plans will also reimburse a portion of your eye exam and eyewear costs at Walmart Vision Centers if you have out-of-network benefits.
The exact coverage will depend on your specific EyeMed plan tier. For example, Bronze plans have lower reimbursements vs. Platinum plans.
Based on EyeMed‘s average reimbursement rates, your out-of-pocket costs at Walmart may look something like:
- Eye Exam
- EyeMed Network: $10 copay
- Walmart Out-of-Network: $110 reimbursement, $90 out-of-pocket
- EyeMed Network: $20 copay
- Walmart Out-of-Network: $240 reimbursement, $160 out-of-pocket
Again, being out-of-network means you pay a lot more! Always check your plan‘s out-of-network coverage details.
How Do You File a Vision Insurance Claim at Walmart?
To get reimbursed for any vision care services at Walmart, you‘ll need to file a claim with your vision insurer:
1. Save your itemized receipt from Walmart showing all services received and payment amounts.
2. Obtain an out-of-network claim form from the VSP or EyeMed website.
3. Submit the form along with your receipt. You can submit online or print and mail in the form.
4. Allow up to 30 days for reimbursement. Both VSP and EyeMed try to make this process simple for Walmart customers.
I recommend submitting the claim as soon as possible while the details are still fresh. Based on my experience, allowing 2-3 weeks is reasonable for reimbursement turnaround.
Are VSP and EyeMed the Same?
VSP and EyeMed are two distinct vision insurance companies that compete for customers. Some key differences:
VSP is one of the largest vision insurers in the US. They also own Visionworks retail optical centers.
EyeMed is owned by EssilorLuxottica, a large eyewear company that owns LensCrafters, Pearle Vision and other brands.
Both offer routine eye care coverage and discounts on services like LASIK surgery.
Plan options, provider networks, and pricing structures vary between the two companies.
|Ownership||privately owned||owned by EssilorLuxottica|
|Members||80+ million||65+ million|
|Network Size||over 40,000 eye doctors||over 90,000 providers|
|Plans Available||Vision Care Plan, Premier Plan||Bronze, Silver, Platinum|
While VSP and EyeMed have some similarities in terms of core vision coverage, they remain completely separate providers.
The Bottom Line
Hopefully this guide gave you a clear overview of how your VSP or EyeMed benefits can be used at Walmart Vision Centers and what to keep in mind.
The key takeaways are:
- Walmart is out-of-network for both VSP and EyeMed
- You‘ll need out-of-network coverage for reimbursement
- Costs will be higher and reimbursements lower compared to in-network
- File claims promptly for reimbursement
- VSP and EyeMed are competitors in vision insurance
Knowing the ins and outs of using your vision insurance at Walmart‘s vision centers allows you to be an informed consumer and maximize your eye care benefits. Let me know if you have any other vision insurance questions!