Quick Reference to VSP
®
Vision Care Plans
Below is just a sample of VSP plans and benefits.
These plans are recommended for clients with less than 500 employees.
Contact your VSP representative for a customizable eye health and wellness solution.
VSP Signature Plan
®
VSP Choice Plan
®
VSP Exam Plus
SM
Plan
Premier Coverage Full Coverage Basic Exam Coverage
Plan Customization
Employer-paid Plan Option
Minimum of two
enrolled employees
Minimum of 10
enrolled employees
Minimum of 10
enrolled employees
Voluntary Plan Option
Minimum of 10
enrolled employees
Minimum of 10
enrolled employees
N/A
Frequency Options
✓ ✓ ✓
Customizable Exam/ Material Copays
✓ ✓ ✓
Exam Coverage
WellVision Exam
®
Covered in full Covered in full Covered in full
Routine Retinal Screenings
Covered after no more than a $39 copay
✓ ✓
N/A
Lens Coverage
Basic Prescription Lenses
Glass or plastic, single vision, lined bifocal,
lined trifocal, or lenticular
Covered in full Covered in full 20% off
Covered with a copay, saving an
average of 35-40%
Most popular are covered with a
copay, saving an average of
20-25%
Patient cost:
Progressives: Covered
Anti-reflective: $37
Photochromics: $70
Scratch coating: $15
Polycarbonate: $23
Valid only through VSP doctors, Costco®
Optical prices already include savings
Patient cost:
Progressives: Covered
Anti-reflective: $41
Photochromics: $75
Scratch coating: $17
Polycarbonate: $31
Valid only through VSP doctors, Costco®
Optical prices already include savings
Dependent children are eligible for
covered polycarbonate
prescription lenses
Dependent children are eligible for
covered polycarbonate
prescription lenses
Frame Coverage
Frame
Costco
®
Optical allowance may differ but is of equivalent
value; 20% off not available at Costco as price already
includes savings.
$130 retail allowance,
plus 20% off any amount above
the allowance
$130 retail allowance,
plus 20% off any amount above
the allowance
20% off
Wholesale Guarantee
Frame allowance backed by a wholesale
guarantee, meaning VSP fully covers more
frames than retail allowance plans
✓ ✓
N/A
Extra $20 Allowance
On featured brands like bebe®, Calvin Klein,
Flexon, Lacoste, Nike, Nine West and more
Featured frame brands and promotion subject to change,
promotion doesn’t apply to Costco
®
Optical.
✓ ✓
N/A
Additional Pairs of Glasses or Sunglasses
All members receive 20% off unlimited additional pairs of
glasses from any VSP doctor within 12 months of last eye
exam. Signature Plan members also receive 30% off on
glasses purchased same day as eye exam from the same
VSP doctor that did exam. 20% and 30% off not available at
Costco® Optical as price already includes savings.
30% off (same day)
20% off (throughout the year)
20% off 20% off
Contact Lens Coverage
Elective Contact Lenses
(prescription contact lenses, in lieu of
glasses)
15% off not available at Costco® Optical as price already
includes savings.
Fitting & Evaluation: Standard
and premium fit: covered in full
after copay (15% off contact lens
exam services; copay will never
exceed $60)
Contact Lenses:
Materials covered in full up to
$130
Fitting & Evaluation: Standard
and premium fit: covered in full
after copay (15% off contact lens
exam services; copay will never
exceed $60)
Contact Lenses:
Materials covered in full up to
$130
15% off contact lens exam services
Contact Lens Rebates
Exclusive mail-in rebates, savings, and
coupons on eligible contact lenses
Subject to change
✓ ✓ ✓
Necessary Contact Lenses
Covered for members with specific
conditions that contacts would provide better
visual correction
Not available at participating retail chains
✓ ✓
N/A
Lens Enhancements
Lens enhancement savings vary by plan and lens
enhancement selected. Prices shown reflect standard
selections; premium or custom options may also be
available.
20% off
Quick Reference to VSP® Vision Care Plans
VSP Signature Plan
®
VSP Choice Plan
®
VSP Exam Plus
SM
Plan
Premier Coverage Full Coverage Basic Exam Coverage
Value-added Programs
VSP Primary EyeCare Plan
SM
Supplemental coverage for medical eye
conditions, such as pink eye, by a VSP
doctor; no referral necessary
✓ ✓ ✓
Eye Health Management Program
SM
Member materials and care from your VSP
doctors that support your wellness initiatives
✓ ✓ ✓
Average 15% off
or 5% off
promotional offer
Average 15% off
or 5% off
promotional offer
Average 15% off
or 5% off
promotional offer
Members who’ve had vision
correction surgery can use their
frame benefit for sunglasses,
instead of a pair of prescription
glasses
N/A N/A
Low Vision
For people with extremely limited vision, not
fully correctable by glasses or contacts
Exam and allowance for low
vision aids every two years
Exam and allowance for low
vision aids every two years
N/A
Plan Enhancements
Enhance your plan even further by adding
one of these optional supplemental benefits
Covered Contacts
Covers contact lens services and an annual
supply of contacts in addition
to glasses
✓
N/A N/A
Second Pair
Covers a second pair of glasses or an
allowance for contact lenses
✓ ✓
N/A
Vision Therapy
Coverage for patients with specific visual
dysfunctions, such as turned eye or lazy eye
✓
N/A N/A
Specialty Care Plans
Available as standalone plans or as
supplemental benefits
ProTec Safety® Plan
Provides protective eyewear that meets ANSI
and OSHA standards. Includes prescription
lenses, and a selection of covered-in-full
safety frames from ProTec Eyewear®
✓ ✓
N/A
Computer VisionCare
SM
Plan
Helps detect eye health and vision issues
attributed to regular computer use; includes
exam, prescription glasses, and patient
education
✓
N/A N/A
Other Plan Offerings
Based on applicable laws, benefits may vary by doctor location.
©2020 Vision Service Plan. All rights reserved.
CL- Rev. 3/20
Exam Core Voluntary Materials Plan
The exam is covered in full by the employer with a voluntary employee-paid materials buy-up option.
VSP Laser VisionCare
SM
Program
Discounts on LASIK, Custom LASIK, and
PRK, plus patient education
Wavefront technology with the microkeratome surgical
device only. Other LASIK procedures performed at
additional cost. Discounts only available from VSP-
contracted facilities.
2-9 Employee Program
VSP has an employer-paid program for clients with 2 to 9 employees. Completely administered online, this premier full-service plan offers clients choice,
flexibility, and maximum value through a VSP network doctor.
