Page 14 - Excelligence 2022 Benefit Guide
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Vision plan
The vision plan through VSP 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 providers.
Exam
Frames
Lenses
● Single vision lenses
● Bifocal lenses
● Trifocal lenses
Contact Lenses
● Elective
Frequency
● Exam
● Lenses
● Frames
● Contact lenses
Your coverage with out-of-network providers
Get the most out of your benefits and greater savings with a VSP network doctor. Call Member Services for out-of-network plan details.
Plan Provisions
VSP Vision Plan
In-Network
$10 copay
● $140 allowance for a wide selection of frames
● $160 allowance for featured frame brands
● 20% savings on the amount over your allowance
● $75 Walmart®/Costco® frame allowance
$0 $95-$105 $150-$175
Up to $60 copay
Every Calendar Year
Every Calendar Year Every Other Calendar Year Every Calendar Year
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