

Patients with
out-of-network insurance?
No problem.
See below for how to apply for reimbursement
on prescription eyeglasses or sunglasses.
1. Complete an out-of-network claim.
If the provider is not listed below, visit their website to access forms and information.

Complete the claim form (download below) and submit it along with an itemized receipt to the mailing address shown.
Download Claim Form
EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-711

Complete the claim form (download below) and submit it along with an itemized receipt and a copy of the prescription to the mailing address shown.
Download Claim Form
CignaVision
P.O. Box 385018
Birmingham, AL 35238-5018

Complete the claim form (download below) and submit it along with an itemized receipt to the mailing address shown.
Download Claim Form
Humana Vision Care Plan
Attn: OON Claims
P.O. Box 14311
Lexington, KY 40512-4311

Complete the claim form (download below) and submit it along with an itemized receipt to the email or mailing address shown.
Download Claim Form
Aetna Vision
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111
oonclaims@eyemedvisioncare.com

Log in to DavisVision.com to download a claim form and submit it along with an itemized receipt to the mailing address shown.
DavisVision.com
Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110

Complete the claim form (download below) and submit it along with an itemized receipt to the fax or mailing address shown.
Download Claim Form
United Healthcare Vision
Attn: Claims Department
P.O. Box 30978
Salt Lake City, UT 84130
Fax: 248.733.6060

Complete the claim form (download below) and submit it along with an itemized receipt to the email or mailing address shown.
Download Claim Form
Blue View Vision
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111
oonclaims@eyewearspecialoffers.com
2. Include Itemized Receipt and Required Documentation.
Note: Receipts for Proper Optics frame and lens packages do not break down the cost of frame and lenses separately since they're priced as a package. Most insurance companies split 50/50 between lenses and frames, so if you run into any problems, please contact GSRx customer service.
3. Submit Forms and Documentation to Insurance Company.
To avoid delays, double check all forms are properly filled out and all required documentation is attached.
4. Collect Reimbursement.
Depending on the insurance provider, claims are typically processed and reimbursements received within 2-3 weeks.