Member
Information
Provider Locator
Information for Members
How to Use Your Benefits
How to Use ECPA Access
How to Use ECPA Select
Frequently Asked Questions
Provider Locator
Note: ECPA's provider locator is best viewed with Netscape or Internet Explorer versions 4.0 or later and with a video resolution set to at least 800 x 600. The browser used and the video resolution setting will affect the formatting of information on you screen and may prevent some or all information from being displayed correctly. To quickly find a location near you, enter your zip code. If you provide your address, you can even receive driving directions.
Information for Members
Welcome to ECPA. As an ECPA member, you have choice. All three "Os" – Optometrists, ophthalmologists and opticians – are available to you in both private practice and in retail stores such as LensCrafters.Whether you are an ECPA Access member with access to discounts through ECPA Preferred Pricing or are an ECPA Select member entitled to a full schedule of vision care benefits, you are able to choose from an unlimited selection of eyewear.
As an ECPA member, all that you will ever need to access benefits or savings is your ECPA membership card. For visits to ECPA Providers there is no paperwork for benefits or savings, ever.
How to use your ECPA benefits
ECPA offers a vision care savings program called ECPA Access and a full-benefit plan called ECPA Select.
ECPA Access
With ECPA Access, members use their membership ID card to access ECPA
Preferred Pricing on eyewear and vision care materials.
ECPA Select
With ECPA Select, members receive a schedule of benefits that includes
a vision care examination and either eyewear materials benefits or
savings. This schedule of benefits, provided with membership materials,
identifies the amounts and the frequencies of these benefits that are
covered or provided.
How to use ECPA Access
- One card covers the whole family!
- Select a provider from the customized list provided with your card, call ECPA’s Provider Locator number anytime for nearby provider locations at (800) 221-3272 or use our online provider locator.
- Present your ECPA ID card and purchase eyewear at ECPA preferred pricing. Savings of up to 40% and more are possible. Ask your provider to show you your savings.
- Pay your provider directly. There are no forms or paperwork, ever.
How to use ECPA Select
- Call the ECPA Provider Locator line at (800) 221-3272 or use our online provider locator to find a provider near you.
- Schedule an appointment with your ECPA Provider, identifying yourself as an ECPA member.
- Present your ECPA Membership card to your ECPA Provider. No paperwork is involved; you simply pay your co-payment and any expenses that are not covered.
- A photocopy of your membership card (or your group number and social security number)
- The original full itemized invoice
- A copy of the prescription
Please send your claim to:
ECPA Claims Administration
P.O. Box 8504
Mason, OH 45040-7111
Frequently Asked Questions
What is covered in a comprehensive eye exam?
At ECPA, our focus is on healthy eyes. All of our scheduled benefit plans include a comprehensive vision examination which includes, but is not limited to: case history, including chief complaint, ocular disease and medical history, visual field screening, refraction and treatment plan.
Are contact lens fitting fees included in the vision exam?
Professional contact lens fitting fees are not considered a part of routine eye care and are not included in the vision exam. However, members who receive a contact lens fitting from a provider who also dispenses their contact lenses can apply the excess of their materials benefit, if any, toward the cost of the fitting. It is important to remember that contact lenses must be purchased from the same provider who performed the fitting, and that only the balance of the materials benefit, after purchasing contact lenses, can be applied towards the fitting fee.
Are disposable contact lenses covered?
Disposable contact lenses and daily wear contact lenses are covered under the materials benefit, if part of the plan purchased.
Typically contact lenses are available every 12 or 24 months in lieu of spectacle lenses, depending on your plan. When purchasing disposable contact lenses, members must use their entire allowance in a single purchase. It is important that members use their entire allowance at one time, since subsequent purchases within the same eligibility will be denied until the member becomes eligible again.
Can I purchase contact lenses and glasses?
Members who choose the contact lens benefit elect to receive contact lenses in lieu of frames and spectacle lenses. However, members are entitled to purchase additional materials, like glasses, from ECPA providers at ECPA contracted Preferred Pricing. These purchases can be made as frequently as desired. Preferred Pricing allows ECPA members to purchase high quality eyewear at special pricing that ECPA has negotiated on their behalf. There is no paperwork to fill out. At the time of purchase, members simply pay the provider the Preferred Pricing in full. Members are welcome to ask the provider to show them the savings they received using their ECPA membership card.
Preferred Pricing is not available from non-ECPA providers.
Does ECPA cover nonprescription items like sunglasses?
ECPA does not cover items that are not necessary for vision correction. However, ECPA members will receive a savings when purchasing sundry items, including nonprescription sunglasses through Preferred Pricing, available to them only from ECPA providers.
Are high index lenses covered under the lens benefit?
High index lenses are lenses that are specially processed to be thin. Since high index lenses are cosmetic, they are not covered by the lens benefit. However, EPCA providers will use Preferred Pricing to determine the cost, ensuring that each ECPA member receives a savings on this feature.
How can I find out what benefits are available to me, and how often?
Members can call our automated Easy Access Automated Service Line at (800) 221-3272, 24 hours a day, 7 days a week for information on benefits and providers.
Do I have an ECPA identification number?
Yes. The subscriber’s social security number is his/her ID number, and is the ID number for all eligible members of his/her family.
Do I have to use ECPA providers?
Most programs offer non-ECPA provider coverage, but members will receive lower benefits than if they use ECPA providers. Please refer to your Agreement for Services to determine if non-panel benefits are available to your employees.
Do I need to complete claim forms?
ECPA providers complete the paperwork and send it directly to ECPA. Members pay their applicable copayments, any excess charges above their benefit allowances, and any charges for non-covered services and materials. There are no claim forms to complete.
Non-ECPA providers may provide members with a completed claim form for submission, although it is not necessary for reimbursement Members must submit a fully itemized original invoice in lieu of a completed claim form, together with a copy of their ECPA card directly to ECPA claims for reimbursement.
How often can I use my benefits?
The frequency of benefits appears on the card carrier that accompanies the ECPA card that is provided to all members.
Once the member’s benefits are exhausted, he/she is entitled to purchase materials from ECPA providers at ECPA contracted Preferred Pricing, as frequently as desired. There is no paperwork to fill out. At the time of purchase, members simply pay the provider in full according to the Eye Care Plan of America Preferred Pricing.
Preferred Pricing is not available from non-panel providers.
Do you offer a provider directory?
We do not offer a provider directory because we are continuously adding to our provider network to give our members as much choice and flexibility as possible. Provider information is available around-the-clock through our advanced, Easy Access Automated Service Line, or use our on-line provider locator.These always contain the most accurate, up-to-the-minute Provider information.
Who do I call if I need further information?
Members are encouraged to call our Easy Access Automated Service Line at (800) 221-3272. The automated system will give members information on their benefits and providers in their areas. Customer Service Representatives are also available to members who have additional questions.
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