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Vision
You are eligible for vision coverage through Vision Service Plan (VSP). VSP provides coverage for eye exams and
materials, such as lenses and frames.
VSP Vision Plan
In-Network
Out-Of-Network
Examination
Benefit
$10 copay for exam and glasses
Up to $50
Frequency
1 x every 12 months
In-network limitations apply
Materials
Plan pays 100%
Plan pays 100% (see schedule below)
Eyeglass Lenses
Single Vision Lens
Plan pays 100%
Up to $50
Bifocal Lens
Plan pays 100%
Up to $75
Trifocal Lens
Plan pays 100%
Up to $100
Frequency
1 x every 12 months
In-network limitations apply
Frames
Benefit
$150 allowance (20% discount over
allowance)
Up to $70
Frequency
1 x every 24 months
In-network limitations apply
Contacts (Elective)
Benefit
$120 allowance (instead of glasses)
Up to $105
Frequency
1 x every 12 months
In-network limitations apply