Benefit Guide - People
VISION BENEFITS
Regular eye examinations can not only determine your need for corrective eye wear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone.
VSP CHOICE NETWORKPLAN
BENEFIT
IN-NETWORK
OUT-OF-NETWORK
Eye Exam
$20 copay
Reimbursed up to $50
Prescription Glasses
$20 copay
See below
Frequency Exam Lenses Contact Lenses Frames
Every calendar year Every calendar year Every calendar year Every other calendar year
$150 allowance 80% over $150 allowance
Frames
Reimbursed up to $48
Lenses Single Vision Lenses Bifocal Vision Lenses Trifocal Vision Lenses Lenticular Vision Lenses
Reimbursed up to $48 Reimbursed up to $67 Reimbursed up to $86 Reimbursed up to $126
Included in Prescription Glasses
Contact Lenses Elective
$150 allowance No charge 15% off UCR
Reimbursed up to $120 Reimbursed up to $210 In-Network Only
Medically Necessary Evaluation and Fitting
For additional plan information, please refer to your detailed plan design. In the event of a discrepancy, the carrier Plan Document shall prevail.
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