Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
VSP Vision
Plan Information
Plan Name: VSP Vision
Policy Number: 30102596
Effective Date: 01/01/2025
Provider Network: VSP
Benefit Highlights
In-Network | Out-of-Network Reimbursement |
|---|---|
| Well Vision Exam | Well Vision Exam |
| $10 copay | Up to $45 reimbursement |
| Single Vision Lenses | Single Vision Lenses |
| $0 after $20 member copay | Up to $30 reimbursement |
| Bifocal Lenses | Bifocal Lenses |
| $0 after $20 member copay | Up to $50 reimbursement |
| Trifocal Lenses | Trifocal Lenses |
| $0 after $20 member copay | Up to $65 reimbursement |
| Frames | Frames |
| $120 allowance, 20% savings on the amount over allowance | Up to $70 reimbursement |
| Contacts (in lieu of glasses) | Contacts (in lieu of glasses) |
| $120 allowance | Up to $105 reimbursement |
Frequency | Frequency |
|---|---|
| Exams | Exams |
| Once every 12 months | Once every 12 months |
| Lenses | Lenses |
| Once every 12 months | Once every 12 months |
| Frames | Frames |
| Once every 24 months | Once every 24 months |
| Contacts | Contacts |
| Once every 12 months | Once every 12 months |