NOTE: Receipts must be submitted together at the same time for services and materials purchased (even if purchased on different dates) to receive reimbursement. You must submit your out-of-network reimbursement request with your itemized receipt and the following information: Subscriber's name and address, the patient's name and date of birth, regardless of whether or not you have vision insurance. These funds can be used for prescription eyewear, and the subscriber's unique identification number.
