Vision without Exam

This “materials only” plan is designed for people who have vision coverage through their medical coverage. Those medical plans include coverage for an eye examination, but not glasses or contacts. This plan will help pay for what your medical insurance does not cover.
You may visit any eye care professional. This indemnity vision plan does not have a network. Your coverage is a set dollar amount regardless of which eye care professional you visit.

Benefit VSP Choice Provider Non-Network Provider
Eye Exam Covered in Full $45
Lenses

     Single Vision

     Bifocal

     Trifocal

     Lenticular

     Progressive (Standard)

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

$30

$50

$65

$100

N/A
Contacts

     Fit & Follow-Up Exam

     Elective

$60 Co-Pay

$200

Not Covered

$105
Frames $200 $70
Deductible Exam: $10 / Material: $25
Frequency (Months) Exam: 12 / Lens: 12 / Frame: 24

 

Lens Options at VSP Providers Member Co-Pay
Progressive Lenses (Premium & Custom) $40
Polycarbonate (Standard) Child: $0 / Adult: $33
Dye (Plastic Gradient / Solid Plastic) $15 – $17
Photochromatic Lenses $31 – $82
Scratch Resistant Coating $17 – $33
Anti-Reflective Coating $43 – $85
Ultraviolet Coating $16

VSP Vision Monthly Premium
Member Only

$10.50
Member + Spouse or Child (1 Dependent)

$20
Member + Family (2 or more Dependents)

$29