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A LOOK AT YOUR
VSP VISION COVERAGE
SEE HEALTHY AND LIVE HAPPY BENEFIT DESCRIPTION COPAY
YOUR COVERAGE WITH A VSP PROVIDER
WITH HELP FROM MLB OFFICE
WELLVISION Focuses on your eyes and overall
OF THE COMMISSIONER AND EXAM wellness $10
Every calendar year
VSP. PRESCRIPTION GLASSES $25
$140 featured frame brands
As a VSP® member, you get personalized care allowance
$120 frame allowance
from a VSP network doctor at low out-of-pocket 20% savings on the amount over Included in
costs. FRAME your allowance Prescription Glasses
$65 Walmart®/Sam's Club®/Costco®
frame allowance
VALUE AND SAVINGS YOU LOVE. Every other calendar year
Save on eyewear and eye care when you see a Single vision, lined bifocal, and
VSP network doctor. Plus, take advantage of lined trifocal lenses Included in
Exclusive Member Extras for additional savings. LENSES Impact-resistant lenses for Prescription Glasses
dependent children
PROVIDER CHOICES YOU WANT. Every other calendar year
With an average of five VSP Standard progressive lenses $0
network doctors within six Premium progressive lenses $80 - $90
miles of you, it’s easy to find a LENS Custom progressive lenses $120 - $160
ENHANCEMENTS
Average savings of 40% on other
nearby in-network doctor. Plus, lens enhancements
maximize your coverage with Every other calendar year
bonus offers and additional $120 allowance for contacts; copay
savings that are exclusive to CONTACTS does not apply
Premier Program locations. (INSTEAD OF Contact lens exam (fitting and Up to $60
GLASSES) evaluation)
Like shopping online? Go to eyeconic.com and Every other calendar year
use your vision benefits to shop over 50 brands Retinal screening for members with $0
of contacts, eyeglasses, and sunglasses. diabetes
Additional exams and services for $20 per exam
QUALITY VISION CARE YOU NEED. members with diabetes, glaucoma,
You’ll get great care from a VSP network doctor, or age-related macular
including a WellVision Exam®—a comprehensive degeneration.
exam designed to detect eye and health PRIMARY SM Treatment and diagnoses of eye
EYECARE
conditions, including pink eye,
conditions. vision loss, and cataracts available
for all members.
Limitations and coordination with
PROVIDER NETWORK:
your medical coverage may apply.
VSP Signature
Ask your VSP doctor for details.
EFFECTIVE DATE: As needed
01/01/2021 Glasses and Sunglasses
Extra $20 to spend on featured frame brands. Go to
vsp.com/offers for details.
30% savings on additional glasses and sunglasses,
including lens enhancements, from the same VSP provider
on the same day as your WellVision Exam. Or get 20%
from any VSP provider within 12 months of your last
WellVision Exam.
EXTRA
SAVINGS Routine Retinal Screening
No more than a $39 copay on routine retinal screening
as an enhancement to a WellVision Exam
Laser Vision Correction
Average 15% off the regular price or 5% off the
promotional price; discounts only available from
contracted facilities
After surgery, use your frame allowance (if eligible) for
Contact us: sunglasses from any VSP doctor
YOUR COVERAGE WITH OUT-OF-NETWORK PROVIDERS
800.877.7195 or vsp.com
Get the most out of your benefits and greater savings with a VSP network
doctor. Call Member Services for out-of-network plan details.
©2021 Vision Service Plan. All rights reserved. VSP guarantees coverage from VSP network providers only. Coverage information is subject to change.
VSP, VSP Vision care for life, Eyeconic, and WellVision Exam are registered trademarks,
and VSP Diabetic Eyecare Plus Program is a service mark of Vision Service Plan. In the event of a conflict between this information and your organization’s contract with VSP, the
All other brands or marks are the property of their respective owners. 45943 VCCM terms of the contract will prevail. Based on applicable laws, benefits may vary by location. In the state
of Washington, VSP Vision Care, Inc., is the legal name of the corporation through which VSP does
business.