GEHA will be closed in observance of Thanksgiving on Thursday, November 22, and Friday, November 23. We will reopen at 7 a.m. Central time on Monday, November 26.

Connection Vision Out-of-Network Claim Form

You only need to complete this form if you are visiting a provider that is not a participating provider in the EyeMed network. Please complete and send this form to EyeMed within one (1) year from the original date of service at the out-of-network provider’s office.