How the Plan Works

Under VSP, you can use either a VSP member provider or your own eye care specialist (optometrist,ophthalmologist, and/or dispensing optician). In either case, VSP covers an eye exam and new lenses every 12 months, and new frames every 24 months. Contact lenses are covered in place of lenses and frames for the applicable eligibility period.

Any participating VSP doctor can authorize necessary vision care. All you need to do is call a participating doctor to schedule an appointment. When making your appointment, identify yourself as a VSP member, and provide the following information:

Covered member's Social Security number
Covered member's name
Patient's name and date of birth
Covered member's group name

The doctor will contact VSP to handle the rest of the required paperwork. If there is any problem with your eligibility, the doctor will contact you prior to your appointment.

If you need to find a participating doctor or see if your current eye doctor is in the VSP network, you may log on to VSP's website at www.vsp.com and click on Find a VSP Doctor. You may also call VSP toll-free at 1-800-VSP-7195 (1-800-877-7195). You will be connected with an automated system that will verify your eligibility, and will allow you to enter a doctor's name to determine if he or she is in the VSP network.

You may also use a non-VSP doctor. VSP will pay claims for any licensed optometrist, ophthalmologist, or optician. The $15 copayment for lenses and frames applies. You will have to pay the doctor in full for services and supplies, and then file a request for reimbursement from VSP. To be reimbursed, submit a claim form and an itemized receipt. You will be reimbursed for eligible costs up to the vision care benefit limits described in the following pages. Claims must be filed within six months after seeing the doctor.

In emergency cases when immediate vision care is necessary, you can receive care by contacting a VSP Panel Doctor. The VSP Panel Doctor will call VSP for eligibility verification and, if you are eligible, VSP will provide authorization directly to the Panel Doctor. VSP suggests calling Customer Service and coordinating through them first. They will contact the Panel Doctor.

In addition, VSP's website, www.vsp.com, offers you a variety of services, such as:

Help in locating a VSP doctor near your home or office
Verification of your (or a dependent's) eye care coverage, i.e., a summary of co-payment information, contacts' allowance and a list of dates that each eye care service is next available to you
Answers to frequently asked questions about benefits and plan coverage
Information about eye exams and common vision conditions
Separate glossaries of eye care terms and VSP benefit terms