The vision care program is designed to help pay for routine eye exams, glasses and contact lenses. (Treatment of a vision-related illness or injury is covered under your medical plan.) You can choose coverage for yourself and your family, or you can choose to waive coverage. The program is administered by Vision Service Plan (VSP).
VSP has a comprehensive network of private optometrists, ophthalmologists and retail chain affiliates. Each time you need vision care, you can either go to a participating VSP provider or affiliate and receive a higher level of benefits, or you can go outside the network and pay more.
There are no claim forms to file when you use network providers. If you use providers outside the network, you must file a claim and you’ll be reimbursed up to the scheduled amounts shown on the chart below.
For more information about VSP, you can visit www.vsp.com or call 1-800-877-7195 .
|VSP VISION PLAN BENEFITS|
|Deductible (once every 12 months)*||$25 per individual (combined in- and out-of-network)||$25 per individual (combined in- and out-of-network)|
|Vision Exam (once every 12 months)||100%||Up to $40|
|Lenses (once every 12 months)**|
|· Single vision||100%||Up to $40|
|· Lined bifocal||100%||Up to $60|
|· Lined trifocal||100%||Up to $80|
|· Tints||100%||Up to $5|
|Frames (once every 12 months)**|| 100% up to $150 plan allowance;
20% off amount over allowance
|Up to $45|
|Contact Lenses (once every 12 months)**|| Up to $150;
15% discount on contact lens exam (fitting & evaluation)
|Up to $105|
Please note that only one set of lenses and frames or one set of contacts may be purchased every 12 months.
* Applies to all services.
** Extra Savings and Discounts – Get 30% off additional pairs of glasses and sunglasses, including lens options, from the same VSP doctor on the same day as your Well Vision Exam, or get 20% off additional glasses from any VSP doctor within 12 months of your last WellVision Exam.
Keep in mind that you can be reimbursed from the Health Care FSA for vision care expenses that exceed maximum plan benefits or for some services or expenses not covered by the plan.