Vision

 

Vision - Your responsibility:

VSP Choice Network Providers

 

Exam (every 12 months)

$10

Prescription Glasses

$30

Lenses (every 12 months)

•Single vision, lined bifocals and lined trifocal lenses

•Polycarbonate lenses for dependent children

•Scratch resistant coating, covered in full

•Standard progressive lenses, covered in full

•Anti-reflective coating, $25 copay applies if chosen

Frames (every 24 months)

Retail Frame

•Retail Frame of your choice is covered up to $200, plus 20% off any additional out-of-pocket costs.

Featured Frame1

•Featured frame1 of your choice is covered up to $250, plus 20% off any additional out-of-pocket costs.

Contact Lens Care (every 12 months in lieu of glasses)

 

• When you choose contacts instead of glasses, $130 applies to the cost of our contacts.

$60

• The contact lens exam (fitting and evaluation) is in addition to your vision exam to ensure proper fit of contacts.

Out-of-Network Reimbursement

 

Exam (every 12 months)

Up to $45 less $10 copy

Prescription Glasses

 

Lenses (every 12 months)

•Single vision lenses

Up to $30

•Lined bifocal lenses

Up to $50

•Lined trifocal lenses

Up to $65

•Lined lenticular lenses

Up to $100

Retail Frame (every 24 months)

Up to $70 less $25 copay

Contact Lens Care (every 12 months in lieu of glasses)

 

•Elective contact lenses

Up to $105

•Visually necessary contact lenses

Up to $210

1Applies to Altair or Marchon frames only.