BackVSP Vision — Biweekly Contributions
VSP Vision — Vision Coverage
Vision Benefits
Getting your eyes checked regularly is important even if you don’t wear glasses or contacts. We provide quality vision care for you and your family through VSP at no cost to you.
Vision Benefits
| Coverage tier | BIWEEKLY CONTRIBUTIONS |
|---|---|
| Employee Only | $0.00 |
| Employee + Spouse | $0.00 |
| Employee + Child(ren) | $0.00 |
| Employee + Family | $0.00 |
Employee Only
- BIWEEKLY CONTRIBUTIONS
- $0.00
Employee + Spouse
- BIWEEKLY CONTRIBUTIONS
- $0.00
Employee + Child(ren)
- BIWEEKLY CONTRIBUTIONS
- $0.00
Employee + Family
- BIWEEKLY CONTRIBUTIONS
- $0.00
| Feature | IN-NETWORK | FREQUENCY |
|---|---|---|
| Exams - Copay | $10 copay | Once per calendar year |
| Lenses - Single Vision | $25 copay | Once per calendar year |
| Lenses - Bifocal | $25 copay | Once per calendar year |
| Lenses - Trifocal | $25 copay | Once per calendar year |
| Lenses - Lenticular | $25 copay | Once per calendar year |
| Contacts (in Lieu of Lenses and Frames) - Fitting and Evaluation* | Up to $60 fee | Once per calendar year |
| Contacts (in Lieu of Lenses and Frames) - Elective | $150 allowance | Once per calendar year |
| Contacts (in Lieu of Lenses and Frames) - Medically Necessary | $25 copay | Once per calendar year |
| Frames - Copay | $25 | Once every other calendar year |
| Frames - Allowance | $150 | Once every other calendar year |
Exams - Copay
- IN-NETWORK
- $10 copay
- FREQUENCY
- Once per calendar year
Lenses - Single Vision
- IN-NETWORK
- $25 copay
- FREQUENCY
- Once per calendar year
Lenses - Bifocal
- IN-NETWORK
- $25 copay
- FREQUENCY
- Once per calendar year
Lenses - Trifocal
- IN-NETWORK
- $25 copay
- FREQUENCY
- Once per calendar year
Lenses - Lenticular
- IN-NETWORK
- $25 copay
- FREQUENCY
- Once per calendar year
Contacts (in Lieu of Lenses and Frames) - Fitting and Evaluation*
- IN-NETWORK
- Up to $60 fee
- FREQUENCY
- Once per calendar year
Contacts (in Lieu of Lenses and Frames) - Elective
- IN-NETWORK
- $150 allowance
- FREQUENCY
- Once per calendar year
Contacts (in Lieu of Lenses and Frames) - Medically Necessary
- IN-NETWORK
- $25 copay
- FREQUENCY
- Once per calendar year
Frames - Copay
- IN-NETWORK
- $25
- FREQUENCY
- Once every other calendar year
Frames - Allowance
- IN-NETWORK
- $150
- FREQUENCY
- Once every other calendar year
- *Fitting and Evaluation fee applied to contact lens allowance.
VSP Vision — Plan Notes
- Getting your eyes checked regularly is important even if you don’t wear glasses or contacts. We provide quality vision care for you and your family through VSP at no cost to you.
- Vision coverage is provided through VSP at no cost to you (all tiers are $0.00 biweekly); exams, lenses and contacts follow the frequencies shown in the plan summary.
- Get the most out of your benefits and greater savings with a VSP network doctor. Log in to www.VSP.com for out-of-network plan details.