GEHA stands by those who are affected by Hurricane Florence. Customer Care can assist and offer member ID lookups at 877.434.2336. Learn more

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.