
Vision Benefits
| VSP | Vision Plan | |
|---|---|---|
| Plan Benefits | In-Network | Out-of-Network |
| Exam (once every 12 months) | $20 Copay | Up to $45 |
| Material | Lenses & Frames OR Contacts in lieu of glasses | |
| Lenses (once every 12 months) | ||
| Single / Bifocal / Trifocal | $20 Copay | Up to $30 / $50 / $65 |
| Frames (once every 24 months) | $130 Allowance
20% off the cost for additional pairs of prescription glasses and non-prescription sunglasses. |
Up to $70 |
| Contact Lenses (once every 12 months) | Elective Contacts: $130 max allowance Necessary Contacts: Covered in full after $20 copay |
Elective Contacts: $105 Allowance Necessary Contacts: $210 |
| Laser Surgery Discounts at Participating Providers |
Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities. | |