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August 2013
State’s group vision plan offers exception for patients with changed eyeglass prescriptions
The State of Michigan group vision plan normally provides benefit coverage for a patient’s new eyeglass lenses and frames every 24 months. However, if it’s determined that there has been a change in an eyeglass prescription, the patient’s new lenses and frames are eligible for coverage every 12 months.
For electronic claim submissions, providers should indicate that there has been a change in the prescription in the designated area on the 837 claim record. Paper claim submissions sent to Blue Cross Blue Shield of Michigan should include a copy of the prescription, or they should include supporting documents that indicate there has been a change in the prescription.
Please submit paper claims to:
Blue Cross Blue Shield of Michigan
Mail Code L07A
232 S. Capital Ave.
Lansing, MI 48933
Or fax paper claims to:
1-866-238-3645
(Note: The fax cover letter should indicate that it is a SOM vision prescription change request.)
Benefit coverage for eyeglass lenses and frames
- Vision exams: One every 12 months (must be performed by an optometrist or ophthalmologist)
- Lenses and frames: One set every 24 months (or one set every 12 months if a prescription changes)
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