Page 13 - 2022 Washington Nationals Flipbook
P. 13

VISION PLAN

          Group Number 151138









                                                             Getting your eyes checked every 12 months is not only a
                                                             good idea, but did you know that eye care professionals
                                                             can determine other health conditions when looking into
                                                             your eyes?
         Washington  Nationals'  offers  a  vision
         plan  through  The  Standard (VSP).


         This plan offers you and covered family
         members complete vision coverage

         within the VSP Signature  Network
         including  routine  eye  exams  and            BENEFIT                 IN-NETWORK        OUT-OF-NETWORK
         discounts  on  eye wear purchases. The

         plan also offers Lasik discounts.              Exam                      $10 copay            Up to $45

         You vision plan provides coverage for          Hardware                  $10 copay           See below
         routine eye exams and pays for all or a
         portion of the cost of glasses or contact           Frequency
         lenses.                                        Exam                    Every 12 months     Every 12 months
                                                                                Every 24 months
                                                                                                    Every 24 months
                                                        Lenses
                                                        Frames                  Every 12 months     Every 12 months
                                                                             Covered 100% within the
           To locate a participating vision provider,   Frames                $25 copay.  Wholesale   Up to $70 after $25
                            go to:                                            allowance up to $130      copay
                                                        Lenses
                        www.vsp.com                       Single vision lenses   Covered 100%          Up to $30
                                                          bifocal lenses        Covered 100%           Up to $50
              Additional information is                   trifocal lenses       Covered 100%           Up to $65
              available on the intranet.                Medically necessary     Covered 100%          Up to $210
                                                        contact lenses

                                                        Elective contact lenses   Up to $130       Same as in-network
                                                        in lieu of glasses                              benefit




                                        The above is a brief summary of this benefit option.
                               Click here for more detailed information on this available benefit option.




        2022 Washington Nationals Benefit Guide                                                              Page 13
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