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Options Plus VSP

VSP by Delta Vision provides vision insurance with monthly premiums ranging from $9.95 for an individual to $34.85 for a family. The plan offers comprehensive eye exams and lenses every 12 months and frames every 24 months. For in-network care, exams have a $10 copay and materials have a $25 copay. Frame allowance is $130 and contact lens allowance is $130. Out-of-network reimbursements are provided for services up to $45 for exams, $30-$100 for lenses, and $70 for frames. The plan also covers lens enhancements like anti-glare coating and progressive lenses for an additional fee.

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133 views1 page

Options Plus VSP

VSP by Delta Vision provides vision insurance with monthly premiums ranging from $9.95 for an individual to $34.85 for a family. The plan offers comprehensive eye exams and lenses every 12 months and frames every 24 months. For in-network care, exams have a $10 copay and materials have a $25 copay. Frame allowance is $130 and contact lens allowance is $130. Out-of-network reimbursements are provided for services up to $45 for exams, $30-$100 for lenses, and $70 for frames. The plan also covers lens enhancements like anti-glare coating and progressive lenses for an additional fee.

Uploaded by

Gowell Support
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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VSP by DELTA VISION

BENEFIT SUMMARY

RATES
EMPLOYEE ONLY EMPLOYEE + SPOUSE EMPLOYEE + CHILD(REN) FAMILY
$9.95 $19.90 $20.90 $34.85
BENEFITS
Network/Plan VSP Choice
Exam/lens/frame frequency (months) 12/12/24
Contacts (in lieu of glasses) 12
IN-NETWORK COVERAGE
Eye Exam Copay $10
Materials Copay $25
Frame allowance
Elective contact lens allowance $130
Necessary contact lenses Covered in full after copay
Contact lens fit/evaluation copay $60
Both frames and contacts in same year No; allows contacts in lieu of frames
OUT-OF-NETWORK COVERAGE
Examination, up to: $45
Single vision lenses, up to: $30
Bifocal lenses, up to: $50
Trifocal lenses, up to: $65
Progressive lenses, up to: $50
Lenticular lenses, up to: $100
Frames, up to: $70
Elective contact lenses, up to: $105
Necessary contact lenses, up to: $210
LENS ENHANCEMENTS (MEMBER COST)*
Anti-glare coating $41 single/$41 multifocal
Impact - resistant lenses - adult $31 single/$35 multifocal (covered for children)
Progressive lenses Standard progressive lenses are covered
Light-reactive lenses $75 single vision/$75 multifocal
Scratch resistant coating $17 single vision/$17 multifocal

*Prices shown reflect the standard plastic price for each respective category. Premium lens enhancement prices may
vary. Prices may vary and are valid only through VSP Choice Network and are subject to change without notice.

VISION PROVIDER LOOKUP

Visit: https://www.vsp.com/eye-doctor
Search by Location, Office Name, or Doctor Name

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