Overview

To help you keep your vision strong and eyes healthy, vision coverage from Vision Service Plan (VSP) covers annual exams and correction treatment. The coverage saves you money on eligible vision care expenses such as eye exams, glasses, and contact lenses.

Your vision plan options are:

Low Plan

designed for participants who expect to need only basic services

High Plan

designed for participants who expect to need more comprehensive services

Key features at a glance:

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Flexible designs

that provider you choose and receive benefits.

Affordable coverage

that helps you manage the cost of vision care.

Wide network of providers

that have agreed to negotiated rates, which helps you save money.

In-network cost savings

When you use a VSP network doctor for an eye exam or to purchase eyeglasses, you pay less than if you go outside of the network. In addition, VSP providers take care of all the paperwork, saving you the task of filing claim forms and the need to wait for reimbursement when you receive services from out-of-network providers.

You’ll generally pay less out-of-pocket when you use an in-network eye doctor. Visit VSP for more information.

 

Coverage Details

The Vision Plan covers one eye exam every calendar year and one pair of eyeglasses (or contact lenses) every calendar year for you and each covered dependent, after the applicable copay.

In-network

 Low PlanHigh Plan
Annual deductibleNoneNone
Eye exam$15 copay*$10 copay*
Frames$25 copay; $120 retail allowance$10 copay; $200 retail allowance
Lenses (single, bifocal lined or trifocal lined)$25 copay$10 copay
Lens options
UV coating100% covered100% covered
Tint (solid and gradient)100% covered100% covered
Scratch resistant100% covered100% covered
Basic polycarbonate100% covered100% covered
Standard anti-reflective100% covered100% covered
Contact lenses (in lieu of lenses and frames)
Medically necessary$25 copay$10 copay
Elective$125 allowance$200 allowance
Other servicesIn-network discounts available

Out-of-network (copays apply to out-of-network billed amounts)

 Low PlanHigh Plan
Annual deductibleNoneNone
Eye exam$50 allowance$50 allowance
Frames$70 retail allowance$70 retail allowance
Lenses
Single$50 allowance$50 allowance
Bifocal lined / Progressives$75 allowance$75 allowance
Trifocal lined$100 allowance$100 allowance
Lenticular$125 allowance$125 allowance
Lens options
UV coatingNot coveredNot covered
Tint (solid and gradient)$5 allowance$5 allowance
Scratch resistantNot coveredNot covered
Basic polycarbonateNot coveredNot covered
Standard anti-reflectiveNot coveredNot covered
Contact lenses (in lieu of lenses and frames)
Medically necessary$210 allowance$210 allowance
Elective$125 allowance$125 allowance
Other servicesN/A
Services not covered
  • Eye exams as a condition of employment, medical or surgical treatment (may be covered under Medical Plan)
  • Nonprescription lenses
  • Prescription goggles
  • Safety eyewear
  • Replacement and repair of lost or broken lenses
  • Vision training
  • Services covered by Workers’ Compensation
  • Two pairs of glasses instead of bifocals
 

Using Your Vision Plan

Here’s how to make the most of your vision benefits:

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Use VSP providers.

When you use a VSP network doctor for an eye exam or to purchase eyeglasses, you pay less than if you go outside the network. In addition, VSP doctors take care of all of your paperwork; there are no claims to file. If you don’t use a VSP doctor, you’ll receive an allowance toward your incurred expenses. You’ll pay for expenses when you receive them, then submit a claim for plan reimbursement.

File all claims promptly.

If you use an out-of-network provider, you must file your claim within six months of the date of service.

Use VSP discounts.

Visit VSP for a list of available discounts.

Eyeconic — the VSP online eyewear store

Eyeconic is an online store where plan participants can purchase prescription and non-prescription eyewear. Shop online at Eyeconic and choose from the most popular brands of designer eyewear and contact lenses, at competitive prices. All VSP members receive a 20% discount on prescription and non-prescription eyewear purchased through the online store.

What’s more, as a VSP member, you’ll enjoy the highest savings available when you use your in-network VSP insurance for prescription glasses or contact lenses.

Diabetic EyeCare Plus program

If you have diabetic eye disease, glaucoma, or age-related macular degeneration (AMD), you can receive routine care and follow-up medical eye services at your VSP doctor for a $20 copay. If you have diabetes but do not show signs of diabetic eye disease, you can also receive preventive retinal screenings at no cost to you.

To get started, find a VSP doctor by calling 1-800-877-7195 or visiting VSP. No VSP ID card is needed — simply inform your doctor’s office that you have VSP coverage.

Member and website support

For a listing of providers in your area who participate in the VSP network, call toll-free 1-800-877-7195 or visit the VSP website. Your VSP group number is 12227971.