VSP Benefit Summary

Vision coverage is provided through VSP, which has an extensive network of doctors. When you use a VSP doctor, all eligible services are covered at no cost to you after you meet the $15 copayment. You may also visit a non-VSP provider; however, you pay the entire cost at the time you receive services and file a claim for reimbursement.

	VSP PROVIDER	NON-VSP PROVIDER
Copayment	You pay $15 for exam and glasses.	You pay $15 plus any amount above VSP's plan allowance.
Exam—once every 12 months ¹	After your copay, the plan pays 100%.	The plan reimburses you up to $50.
Lenses—once every 12 months¹ (standard lenses only	After your copay, the plan pays 100% for standard types of lenses, including polycarbonate lenses for dependent children. Progressive lenses and other lens enhancements are available at a discount.	The plan reimburses you up to $50 for single vision lenses, $75 for bifocal and progressive lenses, and $100 for trifocal lenses.
Frames—once every 24 months¹	After your copay, the plan pays 100% up to a $180 allowance for a wide selection of frames, $200 allowance for featured frame brands, and you receive 20% off the amount over your allowance. The plan also has an $100 allowance for Costco frames.	The plan reimburses you up to $70.
Elective Contacts—once every 12 months in lieu of lenses and frames. If you choose contacts, you will be eligible to purchase a frame 12 months from the date you purchased your contacts.	After your copay, the plan pays 100% up to a $150 allowance for the contacts and the contact lens exam (fitting and evaluation); you receive 15% off the cost of the contact lens exam for the amount over your allowance.	The plan reimburses you up to $105.
¹ Frequency is based on your last date of service.

Extra Benefits, Discounts, and Savings Through VSP Providers

Suncare benefit: $180 allowance for ready-made non-prescription sunglasses instead of prescription glasses or contacts. If you choose non-prescription sunglasses, you’ll be eligible for lenses or contacts 12 months and frames 24 months from the date you purchased your sunglasses.
Discounts on additional glasses: 30% off additional glasses and sunglasses, including lens enhancements, from the same VSP doctor on the same day as your vision exam OR 20% off from any VSP doctor within 12 months of your last exam.
Laser vision discounts: Average 15% off the regular price or 5% off the promotional price. After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor.
Routine retinal screening: You pay no more than $39 on routine retinal screening as an enhancement to a vision exam from a VSP doctor.
Primary Eyecare: $20 copay per visit for treatment and diagnosis of eye conditions like pink eye and vision loss and monitoring of cataracts, glaucoma, and diabetic retinopathy.