Vision at a glance
Here’s a look at what services are included in your coverage and the copay amount you will pay when you use the VSP network. When you go out of the VSP network for vision services, you will pay for your services up front and then be reimbursed for only a certain amount of each expense.
|Service||Description||Frequency||Your copay||Out-of-network reimbursement|
|Eye exams||Well Vision Exam focuses on your eye health and overall wellness covered in full||Every 12 months||$10||Up to $45|
|Lenses||Glass or plastic, single vision, lined bifocal, lined trifocal or lenticular prescription lenses are covered in full||Every 12 months||$25
(lenses & frames)
|Up to $30/$50/$65|
|Frames||Frames are covered up to the retail allowance
|Every 24 months||Up to $70|
|Contact lenses||Elective contact lens materials are covered up to $130 toward any type of prescription contact lenses, instead of eyeglasses||Every 12 months||Up to $60
(fitting & evaluation)
|Up to $105|
The features listed above show only the basic services covered through the plan. For more information or to find a vision provider near you, visit www.vsp.com or call 800.877.7195.