Your Vision Care Benefits

Vision Benefit Summary

Service or Supply

 Maximum annual benefit

Refractive eye exam

(Provided through MESVision for all employees and dependents, including in Hawaii)

 Up to $60 once per  calendar year                           
Covered eyewear, glasses (frames and lenses) and contacts (including disposable contacts) prescribed by a doctor and purchased from the Costco Optical Department                          Up to $175, once per      calendar year                                                                              

 

How the Plan Works

The plan pays benefits for the following services and supplies: 

Eye exams

The plan will pay up to $60 per enrolled person for one routine (“refractive”) annual vision exam per calendar year. This includes exams received from any MESVision in-network providers, including the Costco Optical Department. Click here to find a MESVision network provider.

If there is no Costco or MESVision Provider within 25 miles of your work location you may see any provider you choose for your annual refractive eye exam. However, you will be required to pay for this visit out-of-pocket and submit a MESVision claim form for reimbursement.

Eyewear purchased from the Costco Optical Department

The plan will pay up to $175 per calendar year for prescription eyeglasses and contact lenses (including disposable lenses). Benefits are provided only once per year for expenses you incur on a single date. For example:

  • If you buy a set of eyeglasses and a pair of contacts during one visit, for a combined bill of $200, the plan will pay $175 and you’ll pay the balance.
  • If you buy only one set of eyeglasses during one visit for $100, the plan will pay $100 but you will forfeit $75 (the remainder of the maximum annual benefit). No further benefits will be payable and you will be responsible for the full cost of any other eyewear you buy for the rest of the year.

 Eyewear purchased from non-Costco Optical Department providers

These expenses are only covered in the following circumstances:

  • If there is no Costco Optical Department within 25 miles of your location, you may buy your prescription glasses or contacts from any MESVision in-network optical provider, then submit a claim for reimbursement along with proof of your purchase to the Costco Employee Benefits Department.
  • If Costco Optical provides a written confirmation they could not provide the lens or appropriately fitting frames necessary to fill your prescription, you may go to a non-Costco optical provider for the eyewear you need. To get reimbursed, you must submit your claim along with the letter from Costco Optical to the Costco Employee Benefits Department. 
To get reimburseed for eyewear purchased from a non-Costco Optical Department provider, submit a Vision Eyewear Claim Form.
 

What's Not Covered

  1. Glasses, contact lenses or sunglasses with a non-prescription lens, including ophthalmic frames with polarized lenses, even if your doctor writes a prescription
  2. Charges in excess of the amounts listed in the Vision Benefit Summary above
  3. Cosmetic contacts
  4. Replacement of lost or broken frames and/or lenses
  5. Frames, lenses or contacts purchased at other than a Costco Optical Department, except as described above.