Vision Benefits

Vision insurance offers coverage for the routine care of your eyes and may provide coverage for eyeglasses and contact lenses. Your plan will pay for these services based upon the schedule below. Be sure to check your plan certificate for details.

Keep in mind that your costs will generally be lower if you choose an in-network eye-doctor. To find an in-network eye-doctor, please visit www.vsp.com/eye-doctor.

VSP	In-Network Member Cost	Out-of-Network Reimbursement
Exam Copay includes dilation as necessary	$10	Up to $40
Retinal Imaging	Up to $39	Not Covered
Lenses Copay Lenses Copay Single, Bifocal, Trifocal, Lenticular	$25 Copay	Up to $30/$50/$65/$100
Frames Allowance Costco, Walmart, Sam's Club	$130 allowance+ 20% off balance over $70 allowance	Up to $70 N/A
Contacts Allowance Elective Medically Necessary Elective Fitting & Evaluation	$130 allowance (copay waived) $25 Copay; then covered Up to $60	Up to $120 (copay waived) Up to $210 Included in Contact Lens alowance
Frequency
Exam	Once every calendar year	Once every calendar year
Frames	Once every other calendar year	Once every other calendar year
Lenses	Once every calendar year	Once every calendar year
Contacts	Once every calendar year	Once every calendar year

	Per Pay Period Cost
Employee	$0.42
Employee + Spouse	$2.68
Employee + Child(ren)	$2.73
Family	$4.32

Downloads

Summary of Benefits

Provided By

Guardian/VSP

Provider Website

https://www.vsp.com/

Customer Service

877.814.8970