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Want to submit a claim form to your Vision Insurance company?
Below you can find some useful information.
Click the provider names below to jump to their sections.
If you can't find your vision insurance company below, click here to download a generic reimbursement form.
Advantica
Davis Vision
EyeMed
Humana Vision
Spectera
Superior Vision
Vision Benefits
VSP
Advantica
You can get your DharmaCo.com purchase reimbursed by Advantica if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-866-425-2323.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Advantica
Attn: Claims Department
3290 Pine Orchard Lane, Suite C
Ellicott City, MD 21042
NOTE: You must submit your out-of-network reimbursement request within one year from the date of purchase.
Davis Vision
You can get your DharmaCo.com purchase reimbursed by Davis Vision if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-800-999-5431.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110
NOTE: Your out-of-network reimbursement form must be submitted within 180 days from the date of purchase.
EyeMed
You can get your DharmaCo.com purchase reimbursed by EyeMed if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-866-4EyeMed (439-3633).
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111
NOTE: Your out-of-network reimbursement form must be submitted within one year from the date of purchase.
Humana Vision
You can get your DharmaCo.com purchase reimbursed by Humana Vision if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-866-537-0229.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Humana Vision Care Plan
Attn: OON Claims
P.O. Box 14311
Lexington, KY 40512-4311
NOTE: Your out-of-network reimbursement form must be submitted within one year from the date of purchase.
Spectera
You can get your DharmaCo.com purchase reimbursed by Spectera if out-of-network benefits are included in your plan.
You can review your benefits here.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Spectera Claims Department
P.O. box 30978
Salt Lake City, UT 84130
Or Fax: 248-733-6060
NOTE: 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, and the subscriber’s unique identification number. This number can be found on your membership card, on the Spectera website, or by calling 1-800-638-3120. For convenience, you can complete our blank out-of-network reimbursement form.
Superior Vision
You can get your DharmaCo.com purchase reimbursed by Superior Vision if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-800-507-3800.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Superior Vision Services
Attn: Claims Processing
P.O. Box 967
Rancho Cordova, CA 95741
Or Fax: 916-852-2277
Vision Benefits of America
You can get your DharmaCo.com purchase reimbursed by Vision Benefits of America if out-of-network benefits are included in your plan.
You can review your benefits here. or call 1-800-432-4966.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
Vision Benefits of America
300 Weyman Plaza, Suite 400
Pittsburg, PA 15236-1588
VSP
You can get your DharmaCo.com purchase reimbursed by VSP if out-of-network benefits are included in your plan.
You can review your benefits here or by calling 1-1-800-877-7195.
Submit your completed reimbursement form and itemized DharmaCo.com receipt to:
VSP
P.O. 997105
Sacramento, CA 95899-7105