Page 10 - Cytokinetics 2022 Benefits Guide
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Vision plan
We offer a vision plan through VSP. The vision plan provides coverage for routine eye exams and pays for all or a
portion of the cost of glasses or contact lenses. You can choose any provider; however, you always save money if
you see in-network contracted providers.
VSP Plan
Plan Provisions In-Network Out-of-Network
Exam $10 copay Up to $50
$130 allowance
Frames plus 20% off balance Up to $70
over your allowance*
Lenses
• Single vision lenses Covered at 100%* Up to $50
• Lined Bifocal lenses Covered at 100%* Up to $75
• Lined Trifocal lenses Covered at 100%* Up to $100
Contact Lenses
• Elective Up to $130 Up to $105
• Medically necessary Covered at 100%* Up to $210
Frequency
• Lenses 12 Months 12 Months
• Frames 12 Months 12 Months
• Contact lenses 12 Months 12 Months
*Subject to copay
Contact Lens allowance is in lieu of lenses and frames
NOTE: This information summarizes the plans and is not intended to present complete details. Actual terms are governed by the master policies.
Vision Service Plan (VSP)
Phone: 800-877-7195
Website: www.vsp.com
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