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Summary of Vision Benefits

Coverage with a VSP Doctor

Co-Pay

Well Vision Exam

One each calendar year

$10

Prescription Lenses

One set (2 lenses) each calendar year single vision, lined bifocal & lined trifocal lenses

No Co-Pay

Polycarbonate lenses for dependent children 35-40% savings on all non-covered lens options

No Co-Pay

Frames

One every other calendar year allowance. $130 allowance for a wide selection of frames. 20% off the amount over your allowance.

No Co-pay up to $130

OR

Contact Lenses

One pair each calendar year ($130 allowance for contacts and the contact lens exam)

No Co-Pay up to $130 allowance

Note: If you chose contact lenses you will be eligible for a frame benefit one calendar year from the date the contact lenses were obtained.