Vision Benefits

You and your dependents are each allowed up to the maximum benefit of $450 per eligibility period to help pay for eligible vision services. After you pay for eligible vision services, you are reimbursed by the Fund, up to the $450 limit.

If purchasing more than (1) one vision benefit for any combination of lenses, frames, or contact lenses it must be purchased within 30-days of the first purchase and submitted as (1) one claim. 

Example 1: You go to a licensed optometrist on June 15 and purchase prescription eyeglass lenses and frames. The glasses cost $100. You have until July 15 to use up the balance. In this example, you purchase a second pair of glasses ($100) on July 1. You then purchase prescription contact lenses that cost $150 on July 14.

Example 2: Your dependent purchases a year’s supply of prescription contact lenses on August 15. The total cost is $500. The Fund reimburses you $450 for your dependent’s claim. Your dependent pays $50 out-of-pocket. Your dependent will not receive another $450 vision benefit until the next “eligibility period.”

• You and your dependents receive the $450 vision benefit once every “eligibility period.”
• You and your dependents can use the $450 vision benefit during your “eligibility period.” However, you have 30 days after your first service to use up the entire benefit.
• While you have 30 days after the date of your first service to use up the entire benefit, you can only submit in (1) one vision claim per a member and/or dependent during your “eligibility period.”
• Your “eligibility period” starts on the date of your first vision service.

Vision Claims must be submitted within 12-months from the date of service and in its entirety. You may only submit one (1) claim every “eligibility period” per a person.

Vision services include:

• Lenses,
• Frames and
• Contact lenses.

Vision services DO NOT include:

• Eye exams,
• Contact lens fittings,
• Safety glasses and non-prescription lenses and
• Services from International Optical (Note: all other vision care providers are accepted)

You and your dependents will be reimbursed up to the $450 maximum allowance. You and your dependents each can choose to apply the $450 towards any combination or amount of eligible services.

You can choose to visit any licensed vision provider. Providers include:

• Ophthalmologists and
• Optometrists.

Make an appointment with your vision provider and go for your service.

Afterwards, send a Vision Claim Form (PDF) Form to the Fund Office to be reimbursed.

You should contact the Fund Office to check your or your dependent’s eligibility date.

After you pay for your vision service, you can fill out a Vision Claim Form.

Any ineligible, incomplete or missing information may result in a claim being delayed or denied. Make sure that all documentation is included, before submitting your completed vision claim to the Fund Office.

Return completed vision claim form(s), itemized paid bills, receipts, and proof of payment to the Fund Office.

Mailing Address:

Cambridge Public Employees Dental & Vision Fund

125 CambridgePark Drive, Suite 104

Cambridge, MA 02140

Email Address:

visionclaim@cdvfund.org

PDF format only on emailed vision claims – must include scanned claim form, paid itemized bills, receipts, and proof of payment.