Vision Coverage
Keep your vision clear with regular eye exams.
With your Vision Preferred Provider Organization Plan, you can:
- Go to any licensed vision specialist and receive coverage. Just remember, your benefit dollars go further when you stay in-network
- Choose from a large network of ophthalmologists, optometrists and opticians, from private practices to retailers like Costco Optical, Walmart, Sam’s Club and Visionworks
| Vision Care Services | Member Cost/Benefit In-Network |
Member Out-of-Network Reimbursement | ||
|---|---|---|---|---|
| Provider Network | VSP | |||
| Eye health exam, prescription and refraction for glasses | $10 Copay | Up to $45 | ||
| Retinal Imaging | Up to $39 Copay | |||
| Frames and Lenses | $25 Copay | |||
| Standard Corrective Lenses | Single vision Lined bifocal Lined trifocal Lenticular |
Up to $30 Up to $50 Up to $65 Up to $100 | ||
| Frames | $150 Allowance | Up to $70 | ||
| Contact Lenses (instead of eyeglasses) | ||||
| Contact fitting and evaluation | $60 Copay (Max) | |||
| Elective lenses | $150 allowance | Up to $105 | ||
| Necessary Lenses | $25 Copay | Up to $210 | ||
| Frequency | In-Network | Out-of-Network | ||
| Eye exam | Once every 12 months | Once every 12 months | ||
| Lenses or Contact Lenses | Once every 12 months | Once every 12 months | ||
| Frames | Once every 24 months | Once every 24 months | ||
